Provider Demographics
NPI:1528693579
Name:MENTAL HEALTH AND NURSING PC
Entity type:Organization
Organization Name:MENTAL HEALTH AND NURSING PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:MEDARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SISON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:714-831-0821
Mailing Address - Street 1:PO BOX 104371
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91189-4371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:421 N BROOKHURST ST STE 119
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5618
Practice Address - Country:US
Practice Address - Phone:714-361-0898
Practice Address - Fax:714-276-2604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty