# PEDS2PSYCH NP NURSING CORPORATION

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

## Provider details

- **NPI number:** 1598610560
- **Authorized official:** MEDIE JESENA PARROTT MSN, MPH (OWNER/NURSE PRACTITIONER)
- **Authorized official phone:** (707) 200-8194

## Contact information

- **Practice address:** 104 W MENDOCINO AVE, WILLITS, CA 95490-3412
- **Practice address phone:** (707) 200-8194
- **Practice address fax:** (651) 666-1551
- **Mailing address:** 422 LARKFIELD CTR \# 492, SANTA ROSA, CA 95403-1408
- **Mailing address phone:** (707) 370-8774
- **Mailing address fax:** (651) 666-1551

## 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:** 03/03/2026
- **Last updated:** 08/04/2026