Provider Demographics
NPI:1730919929
Name:SERENE MYND PSYCHIATRIC NURSING SERVICES INC
Entity type:Organization
Organization Name:SERENE MYND PSYCHIATRIC NURSING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:916-449-0475
Mailing Address - Street 1:401 VERNON ST STE B
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2600
Mailing Address - Country:US
Mailing Address - Phone:916-449-0475
Mailing Address - Fax:
Practice Address - Street 1:401 VERNON ST STE B
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2600
Practice Address - Country:US
Practice Address - Phone:916-449-0475
Practice Address - Fax:916-848-6949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty