Organization
RAREFORM MENTAL HEALTH NURSING APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIZZY MYISHA PARKER PMHNP (CEO/PMHNP)
(916) 258-2199
Entity
Organization
Contact information
Practice address
5517 CABRILLO WAY, ROCKLIN, CA 95765-5148
(916) 258-2199
Mailing address
785 ORCHARD DR STE 250, FOLSOM, CA 95630-5547
(916) 258-2199
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/26/2025
Last updated
12/26/2025
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