Pacific Ketamine and Wellness, a Professional Nursing Corporation

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PACIFIC KETAMINE AND WELLNESS, A PROFESSIONAL NURSING CORPORATION

Practice address

412 Cedar St Ste C2
Santa Cruz, CA 95060-4369

Phone

(831) 824-4003

NPI assigned

Feb 6, 2025

Last updated

Jun 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaime Jimenez, PMHBCNPI 1710241906

Title

Owner/Nurse Practitioner

Phone

(831) 824-4003

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Jaime Manuel Jimenez, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Cruz, CA
  • NPI 1710241906
  Medicare reassignment NPD Authorized official
• Fern Selzer, PH.D.

  • Psychologist
  • San Jose, CA
  • NPI 1194730598
  NPD (past)

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750982400000",
    "number": "1629882956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CEDAR ST STE C2",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604369",
            "telephone_number": "831-824-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 CEDAR ST STE C2",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604369",
            "telephone_number": "831-824-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC KETAMINE AND WELLNESS, A PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "831-824-4003",
        "authorized_official_credential": "PMHBC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Pacheco
• Sydne Jordan Pacheco
• Vera P Paci Sanchez
• Pacific Collegiate School
• Pacific Composure Psychiatry & Hypnotherapy
• Audra Desiree Packard
• Shanthi Sudha Padala
• Melinda Carol Padgett, PA
• Carlos D Padilla, M.S.
• Catalina Padilla, RN

• Mental Health Clinic/Center (Including Community Mental Health Center) in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.