Provider Demographics
NPI:1053994509
Name:TANDEM PSYCHIATRIC HEALTH, ADVANCED NURSING PRACTICE INC.
Entity type:Organization
Organization Name:TANDEM PSYCHIATRIC HEALTH, ADVANCED NURSING PRACTICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVANTES
Authorized Official - Suffix:JR
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:805-507-5551
Mailing Address - Street 1:1000 TOWN CENTER DRIVE
Mailing Address - Street 2:STE 400
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1123
Mailing Address - Country:US
Mailing Address - Phone:805-654-0926
Mailing Address - Fax:805-654-0949
Practice Address - Street 1:1000 TOWN CENTER DRIVE
Practice Address - Street 2:STE 400
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1123
Practice Address - Country:US
Practice Address - Phone:805-654-0926
Practice Address - Fax:805-654-0949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty