Organization Active NPI

Grace Mental Health Resources, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Folsom, CA
National Provider Identifier
1386306876
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GRACE MENTAL HEALTH RESOURCES, INC
Practice address
50 Iron Point Cir Ste 140
Folsom, CA 95630-8594
Phone
(916) 970-7323
Fax
(916) 357-8865
NPI assigned
Oct 12, 2021
Last updated
Feb 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Julie Bergman, PMHNPNPI 1164808770
Title
Owner
Phone
(916) 970-7323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

50 Iron Point Cir Ste 140
Folsom, CA 95630-8594

Mailing address

50 Iron Point Cir Ste 140
Folsom, CA 95630-8594
Phone (916) 970-7323

Other names 1

  • Grace Mental Health Resources, INC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211021002924 CA Part B Supplier - Clinic/Group Practice 6709274806 Receives reassigned benefits from 2 practitioners
Practice locations: Folsom, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1386306876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 IRON POINT CIR STE 140",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308594",
            "telephone_number": "916-970-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 IRON POINT CIR STE 140",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308594",
            "telephone_number": "916-970-7323",
            "fax_number": "916-357-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MENTAL HEALTH RESOURCES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-970-7323",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Mental Health Resources, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Grace Mental Health Resources, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.