Provider Demographics
NPI:1518723584
Name:SIMPLY PSYCH NURSING; A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SIMPLY PSYCH NURSING; A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:LYLEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, PMHNP- BC
Authorized Official - Phone:714-942-4689
Mailing Address - Street 1:16027 BROOKHURST ST STE I-2025
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1551
Mailing Address - Country:US
Mailing Address - Phone:714-942-4689
Mailing Address - Fax:
Practice Address - Street 1:16027 BROOKHURST ST STE I-2025
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1551
Practice Address - Country:US
Practice Address - Phone:714-360-3559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health