Provider Demographics
NPI:1992571954
Name:COMMUNITY PSYCH NURSING PARTNERS INC
Entity type:Organization
Organization Name:COMMUNITY PSYCH NURSING PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-542-2253
Mailing Address - Street 1:PO BOX 12269
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-0269
Mailing Address - Country:US
Mailing Address - Phone:503-542-2253
Mailing Address - Fax:619-334-3765
Practice Address - Street 1:7050 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1535
Practice Address - Country:US
Practice Address - Phone:503-542-2253
Practice Address - Fax:619-334-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty