Organization
PRUDENT TELEPSYCHIATRY CARE A MEDICAL CORPORATION
Active
Other names
Prudent Telepsychiatry Care
Organization subpart
No
Provider details
NPI number
Authorized official
FELISTA ANUGOM PMHNP, FNP (PRESIDENT)
(866) 214-7214
Entity
Organization
Contact information
Practice address
8880 BENSON AVE STE 125, MONTCLAIR, CA 91763-1661
(323) 632-5868
(866) 214-8786
Mailing address
8880 BENSON AVE STE 125, MONTCLAIR, CA 91763-1661
(866) 214-7214
(866) 214-8786
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
06/07/2021
Last updated
05/10/2024
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