Provider Demographics
NPI:1669197265
Name:LAKEVIEW HORIZON PSYCHIATRIC NURSING SERVICES, PC
Entity type:Organization
Organization Name:LAKEVIEW HORIZON PSYCHIATRIC NURSING SERVICES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHNP-BC
Authorized Official - Phone:530-789-3911
Mailing Address - Street 1:2218 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-5816
Mailing Address - Country:US
Mailing Address - Phone:530-433-4622
Mailing Address - Fax:530-871-0758
Practice Address - Street 1:2218 5TH AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-5816
Practice Address - Country:US
Practice Address - Phone:530-433-4622
Practice Address - Fax:530-871-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty