| Essential Psychiatric Services, A Professional Nursing Corporation | |
|
3160 W Ramsey St Banning CA 92220-3724 | |
| (951) 366-0661 | |
| (855) 706-2054 |
| Full Name | Essential Psychiatric Services, A Professional Nursing Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 3160 W Ramsey St, Banning, California |
| Authorized Official Name and Position | Judith L Diaz (CEO) |
| Authorized Official Contact | 9512505007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Psychiatric Services, A Professional Nursing Corporation 3160 W Ramsey St Banning CA 92220-3724 Ph: (951) 366-0661 | Essential Psychiatric Services, A Professional Nursing Corporation 3160 W Ramsey St Banning CA 92220-3724 Ph: (951) 366-0661 |
| NPI Number | 1710577358 |
|---|---|
| Provider Enumeration Date | 01/18/2021 |
| Last Update Date | 06/11/2023 |
| Certification Date | 06/11/2023 |
| Medicare PECOS PAC ID | 7416323480 |
|---|---|
| Medicare Enrollment ID | O20221016000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710577358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Judith Lynn Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841610219 PECOS PAC ID: 8325414394 Enrollment ID: I20221016000012 |
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