Provider Demographics
NPI:1790369437
Name:QUALITY PSYCHIATRIC HEALTH AND WELLNESS A PROFESSIONAL NURSING CORPORA
Entity Type:Organization
Organization Name:QUALITY PSYCHIATRIC HEALTH AND WELLNESS A PROFESSIONAL NURSING CORPORA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:UGO
Authorized Official - Middle Name:N
Authorized Official - Last Name:NDUBAKU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP, PMHNP-BC
Authorized Official - Phone:661-289-6992
Mailing Address - Street 1:27240 TURNBERRY LN STE 200
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1045
Mailing Address - Country:US
Mailing Address - Phone:661-289-6992
Mailing Address - Fax:866-504-8308
Practice Address - Street 1:27240 TURNBERRY LN STE 200
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1045
Practice Address - Country:US
Practice Address - Phone:661-289-6992
Practice Address - Fax:866-504-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty