Provider Demographics
NPI:1851173546
Name:REMEDY PSYCHIATRIC SERVICES, A NURSING CORPORATION
Entity Type:Organization
Organization Name:REMEDY PSYCHIATRIC SERVICES, A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMBATOVA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:510-936-6525
Mailing Address - Street 1:39116 FREMONT HUB # 1261
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1328
Mailing Address - Country:US
Mailing Address - Phone:510-936-6525
Mailing Address - Fax:510-936-6525
Practice Address - Street 1:10080 N WOLFE RD STE SW3200
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2594
Practice Address - Country:US
Practice Address - Phone:510-936-6525
Practice Address - Fax:510-936-6535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty