Provider Demographics
NPI:1902633662
Name:BLUE JAY INTEGRATIVE PSYCHIATRY, A PROFESSIONAL NURSING CORPORATION
Entity type:Organization
Organization Name:BLUE JAY INTEGRATIVE PSYCHIATRY, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRODEK
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:415-939-0587
Mailing Address - Street 1:3631 TRUXEL RD # 1009
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3604
Mailing Address - Country:US
Mailing Address - Phone:916-538-5810
Mailing Address - Fax:
Practice Address - Street 1:2023 N ST STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-4240
Practice Address - Country:US
Practice Address - Phone:916-538-5810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty