Organization Active NPI

Serenity Falls Behavioral Health a Professional Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1710710728
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SERENITY FALLS BEHAVIORAL HEALTH A PROFESSIONAL NURSING CORPORATION
Practice address
570 W 4TH St # 206
San Bernardino, CA 92401-1405
Phone
(949) 303-9811
NPI assigned
Aug 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Eric Zywicki
Title
Owner
Phone
(949) 303-9811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

570 W 4TH St # 206
San Bernardino, CA 92401-1405

Mailing address

207 Chicago Ave
Huntington Beach, CA 92648-5258
Phone (949) 303-9811

National Provider Directory

National Provider Directory

Locations

570 W 4th St
Ste 206
San Bernardino, CA 92401
Phone (760) 260-8602

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1710710728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 CHICAGO AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485258",
            "telephone_number": "949-303-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 W 4TH ST # 206",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011405",
            "telephone_number": "949-303-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY FALLS BEHAVIORAL HEALTH A PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "ZYWICKI",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-303-9811"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.