| Salvage Psychiatry A Professional Nursing Corporation | |
|
8880 Benson Ave Ste 125 Montclair CA 91763-1661 | |
| (818) 643-4311 | |
| Not Available |
| Full Name | Salvage Psychiatry A Professional Nursing Corporation |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 8880 Benson Ave Ste 125, Montclair, California |
| Authorized Official Name and Position | Taiye Osawe (CEO/DNP) |
| Authorized Official Contact | 8186434311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salvage Psychiatry A Professional Nursing Corporation 8880 Benson Ave Ste 125 Montclair CA 91763-1661 Ph: (818) 643-4311 | Salvage Psychiatry A Professional Nursing Corporation 8880 Benson Ave Ste 125 Montclair CA 91763-1661 Ph: (818) 643-4311 |
| NPI Number | 1043937923 |
|---|---|
| Provider Enumeration Date | 10/21/2022 |
| Last Update Date | 07/05/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 4688044688 |
|---|---|
| Medicare Enrollment ID | O20230428002145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043937923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Taiye Owareye Osawe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396116703 PECOS PAC ID: 1254679921 Enrollment ID: I20190205003531 |
| Provider Name | Virginia Orantes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518206598 PECOS PAC ID: 8628491115 Enrollment ID: I20200630001815 |
| Provider Name | Irene Obanor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598020299 PECOS PAC ID: 0244697316 Enrollment ID: I20230605002153 |
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