Provider Demographics
NPI:1679310759
Name:HEALING MIND PSYCHIATRIC NURSING PC
Entity type:Organization
Organization Name:HEALING MIND PSYCHIATRIC NURSING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:MANE
Authorized Official - Last Name:BULAONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-754-1485
Mailing Address - Street 1:9245 LAGUNA SPRINGS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7991
Mailing Address - Country:US
Mailing Address - Phone:510-754-1485
Mailing Address - Fax:
Practice Address - Street 1:9370 STUDIO COURT DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758
Practice Address - Country:US
Practice Address - Phone:510-754-1485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty