Individual provider Active NPI

Jolanta Urszula Budnik, BSN, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1104375005
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95024546 Issued in CA
Practice address
4540 Kearny Villa Rd Ste 103
San Diego, CA 92123-1564
Phone
(858) 279-1223
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95024546 CA Primary

Addresses

Primary practice location

4540 Kearny Villa Rd Ste 103
San Diego, CA 92123-1564

Mailing address

4540 Kearny Villa Rd Ste 103
San Diego, CA 92123-1564
Phone (858) 279-1223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722003122 CA Practitioner - Nurse Practitioner 1254847601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

4540 Kearny Villa Rd
Suite 103
San Diego, CA 92123-1564
Phone (858) 279-1223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

8881 Fletcher Pkwy
Ste 350
La Mesa, CA 91942
Phone (619) 465-9792

11515 El Camino Real
Ste 100
San Diego, CA 92130
Phone (858) 256-8674

4540 Kearny Villa Rd
Ste 103
San Diego, CA 92123
Phone (858) 259-1223

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jolantabudnik@143255.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1104375005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 KEARNY VILLA RD STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231564",
            "telephone_number": "858-279-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 KEARNY VILLA RD STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231564",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDNIK",
        "first_name": "JOLANTA",
        "middle_name": "URSZULA",
        "credential": "BSN, MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95024546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.