| Mental Wellness For Life A Nursing Corporation | |
|
28212 Kelly Johnson Pkwy Ste 215 Valencia CA 91355-5090 | |
| (818) 688-6826 | |
| (877) 349-4481 |
| Full Name | Mental Wellness For Life A Nursing Corporation |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 28212 Kelly Johnson Pkwy Ste 215, Valencia, California |
| Authorized Official Name and Position | Jacquelyn Victoria Zommick (PRESIDENT/PSYCH NURSE PRACTITIONER) |
| Authorized Official Contact | 8186886826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Wellness For Life A Nursing Corporation 28212 Kelly Johnson Pkwy Ste 215 Valencia CA 91355-5090 Ph: (818) 688-6826 | Mental Wellness For Life A Nursing Corporation 28212 Kelly Johnson Pkwy Ste 215 Valencia CA 91355-5090 Ph: (818) 688-6826 |
| NPI Number | 1982326740 |
|---|---|
| Provider Enumeration Date | 09/16/2022 |
| Last Update Date | 03/11/2024 |
| Certification Date | 03/11/2024 |
| Medicare PECOS PAC ID | 7214307727 |
|---|---|
| Medicare Enrollment ID | O20221227002448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982326740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Reuven J Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508455296 PECOS PAC ID: 8921416595 Enrollment ID: I20210420001293 |
| Provider Name | Jenna Lauren Zommick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952984783 PECOS PAC ID: 2062898901 Enrollment ID: I20220930000253 |
| Provider Name | Jacquelyn Victoria Zommick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073282786 PECOS PAC ID: 4880060540 Enrollment ID: I20221020001627 |
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