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Organization
PEDS2PSYCH NP NURSING CORPORATION
Active
Organization
PEDS2PSYCH NP NURSING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEDIE JESENA PARROTT MSN, MPH (OWNER/NURSE PRACTITIONER)
(707) 200-8194
Entity
Organization
Contact information
Practice address
104 W MENDOCINO AVE, WILLITS, CA 95490-3412
(707) 200-8194
(651) 666-1551
Mailing address
422 LARKFIELD CTR # 492, SANTA ROSA, CA 95403-1408
(707) 370-8774
(651) 666-1551
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/03/2026
Last updated
08/04/2026
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