Provider Demographics
NPI:1568273969
Name:PRAXIS MENTAL HEALTH NURSING PC
Entity type:Organization
Organization Name:PRAXIS MENTAL HEALTH NURSING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:YELICE
Authorized Official - Middle Name:
Authorized Official - Last Name:COREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-251-5770
Mailing Address - Street 1:166 GEARY ST FL 15
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-5631
Mailing Address - Country:US
Mailing Address - Phone:415-251-5770
Mailing Address - Fax:
Practice Address - Street 1:166 GEARY ST FL 15
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-5631
Practice Address - Country:US
Practice Address - Phone:415-251-5770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty