# MINDTREE A NURSING CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467121186
- **Authorized official:** EMILY SAMUEL PMHNP (OWNER)
- **Authorized official phone:** (415) 849-2466

## Contact information

- **Practice address:** 888 PROSPECT ST STE 200, LA JOLLA, CA 92037-4261
- **Practice address phone:** (415) 849-2466
- **Practice address fax:** (415) 376-4529
- **Mailing address:** 888 PROSPECT ST STE 200, LA JOLLA, CA 92037-4261
- **Mailing address phone:** (415) 849-2466
- **Mailing address fax:** (415) 376-4529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/07/2021
- **Last updated:** 08/05/2022