Vista Psychiatric And Primary Care Services
Nurse Practitioner in Berkeley, CA. Organization (NPI-2).
NPI number1023463189
StatusActive
Last updated in NPPESSep 16, 2024
Details
- NPI
- 1023463189
- Entity type
- Organization (NPI-2)
- Legal business name
- Vista Psychiatric And Primary Care Services
- Organization subpart
- No
- Enumeration date
- Apr 26, 2016
- Certification date
- Sep 16, 2024
- Last updated
- Sep 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | – | – | |
| 363LC1500X | Nurse Practitioner, Community Health | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Other names
- Vista Psychiatric And Primary Care Services (Doing Business As)
Practice location
2288 Fulton StSuite 309
Berkeley, CA 94704-1493
Phone 510-517-3156
Mailing address
448 Ignacio BlvdNovato, CA 94949-6085
Authorized official
Yonis A Mudey
Ceo
5105173156
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