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Organization
SERENE HEALTH IPA
Active
Organization
SERENE HEALTH IPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR V MEDINA (CEO)
(619) 821-1505
Entity
Organization
Contact information
Practice address
153 WESTRIDGE DR, WATSONVILLE, CA 95076
(844) 737-3638
(619) 403-9496
Mailing address
9265 SKY PARK CT, SAN DIEGO, CA 92123-4443
(844) 737-3638
(619) 403-9496
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
332U00000X
Home Delivered Meals
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214EN118
—
CA
Enumeration date
07/15/2024
Last updated
10/16/2024
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