Provider Demographics
NPI:1215758321
Name:PSYCHIATRIC NURSING GROUP, INC.
Entity type:Organization
Organization Name:PSYCHIATRIC NURSING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:949-620-6906
Mailing Address - Street 1:2342 APPLE TREE DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-7109
Mailing Address - Country:US
Mailing Address - Phone:949-620-6906
Mailing Address - Fax:
Practice Address - Street 1:2607 WILLO LN
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-4645
Practice Address - Country:US
Practice Address - Phone:949-620-6906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty