Provider Demographics
NPI:1538044565
Name:PSYCHIATRY AND MENTAL HEALTH, A PHYSICIAN ASSISTANT CORPORATION
Entity type:Organization
Organization Name:PSYCHIATRY AND MENTAL HEALTH, A PHYSICIAN ASSISTANT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-804-8227
Mailing Address - Street 1:17074 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1617
Mailing Address - Country:US
Mailing Address - Phone:818-804-8227
Mailing Address - Fax:
Practice Address - Street 1:17074 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1617
Practice Address - Country:US
Practice Address - Phone:818-804-8227
Practice Address - Fax:888-801-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty