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General NPI Number Information
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NPI Number | 1992571954
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Entity Type | Organization
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Legal Business Name | COMMUNITY PSYCH NURSING PARTNERS INC
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 7050 PARKWAY DR
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City | LA MESA
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State | CA
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Zip | 91942-1535
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Country | US
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Telephone | 503-542-2253
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Fax | 619-334-3765
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Provider Business Mailing Address
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Address Line | PO BOX 12269
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City | PORTLAND
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State | OR
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Zip | 97212-0269
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Country | US
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Telephone | 503-542-2253
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Fax | 619-334-3765
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Authorized Official
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Title or Position | CONTROLLER
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Name | ANNA JOY HAYNES
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Credential |
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Telephone | 503-542-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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