1699582775 NPI number — NURTURING MINDS MENTAL HEALTH NURSING A PROFESSIONAL CORPORATION

Table of content: (NPI 1699582775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699582775 NPI number — NURTURING MINDS MENTAL HEALTH NURSING A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NURTURING MINDS MENTAL HEALTH NURSING A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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NPI Number Information

NPI Number:
1699582775
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9245 LAGUNA SPRINGS DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELK GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95758-7991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-229-9927
Provider Business Mailing Address Fax Number:
502-385-6657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8122 KINGSBRIDGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95829-6008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-226-3415
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2024

Additional Information

Authorized Official

Authorized Official Last Name:
ASIDANYA
Authorized Official First Name:
CHINWE
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE OWNER
Authorized Official Telephone Number:
469-226-3415

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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