Provider Demographics
NPI:1437976859
Name:CITYWIDE MENTAL HEALTH, A NURSING CORPORATION
Entity type:Organization
Organization Name:CITYWIDE MENTAL HEALTH, A NURSING CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC MENTAL HEALTH NP
Authorized Official - Prefix:
Authorized Official - First Name:KATIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, MSN
Authorized Official - Phone:323-643-7980
Mailing Address - Street 1:777 S ALAMEDA ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-1656
Mailing Address - Country:US
Mailing Address - Phone:323-643-7980
Mailing Address - Fax:
Practice Address - Street 1:200 S SAN PEDRO ST STE 302
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-5308
Practice Address - Country:US
Practice Address - Phone:323-643-7980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95030258OtherBRN