Organization Active NPI

Serene Health Ipa

  • Psychiatry Physician
  • Ukiah, CA
National Provider Identifier
1336918135
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SERENE HEALTH IPA
Practice address
413 W Standley St Ste a
Ukiah, CA 95482-4347
Phone
(844) 737-3638
NPI assigned
Dec 21, 2023
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Mr. Oscar Medina
Title
President
Phone
(619) 259-6999

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Clinic/Center 261Q00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Home Delivered Meals 332U00000X NU
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Attendant Care Provider 3747A0650X NU
Personal Care Attendant 3747P1801X NU
Homemaker 376J00000X NU
Respite Care 385H00000X NU
Psychiatry Physician 2084P0800X NU Primary
Case Manager/Care Coordinator 171M00000X NU
Supports Brokerage Agency 251X00000X NU

Addresses

Primary practice location

413 W Standley St Ste a
Ukiah, CA 95482-4347

Mailing address

9265 Sky Park CT Ste 100
San Diego, CA 92123-4375
Phone (844) 737-3638

National Provider Directory

National Provider Directory
Tax ID family
Serene Health Ipa Medical Corp19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

9265 Sky Park Ct
Ste 100
San Diego, CA 92123
Phone (619) 329-4483

413 W Standley St
#A
Ukiah, CA 95482

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1336918135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9265 SKY PARK CT STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234375",
            "telephone_number": "844-737-3638",
            "fax_number": "619-403-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W STANDLEY ST STE A",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824347",
            "telephone_number": "844-737-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE HEALTH IPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-259-6999",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.