Organization
SERENE HEALTH IPA MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSCAR MEDINA (CEO)
(619) 259-6999
Entity
Organization
Contact information
Practice address
4433 BROADWAY UNIT B, EUREKA, CA 95503-5741
(844) 737-3638
Mailing address
4849 RONSON CT STE 207, SAN DIEGO, CA 92111-1805
(619) 330-3652
(619) 403-9496
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
332U00000X
Home Delivered Meals
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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