Organization
PSYCHIATRY 121 PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA G HERNANDEZ PMHNP (MANAGER)
(949) 281-9132
Entity
Organization
Contact information
Practice address
1010 W HAYS ST, BOISE, ID 83702-5435
(949) 281-9132
Mailing address
1010 W HAYS ST, BOISE, ID 83702-5435
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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