MEDICARE: MYNDFUL MEDICATIONS NURSING P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1295678472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYNDFUL MEDICATIONS NURSING P.C.

Provider Business Mailing Address
First Line	:	2804 GATEWAY OAKS DR STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-4346
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2804 GATEWAY OAKS DR STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-4346
Country	:	US
Telephone Number	:	619-333-8130
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMY BURCH
Credential	:	PMHNP
Telephone Number	:	619-333-8130

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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