Active NPI
Serenity Falls Behavioral Health a Professional Nursing Corporation
- Psychiatric/Mental Health Nurse Practitioner
- San Bernardino, CA
National Provider Identifier
1710710728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 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 DirectoryLocations
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.