Keena Nicole Harrison, FNP-C
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Riverside, CA
NPI 1790334696 · NPPES record last updated Jul 18, 2023
Key facts
- NPI
- 1790334696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 95013139 (CA)
- Practice address
- 7065 Indiana Ave Ste 110
Riverside, CA 92506-4167 - Phone
- (951) 476-0115
- NPI assigned
- Sep 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210308001627 | CA | Practitioner - Nurse Practitioner | 1254747728 | Reassigns benefits to 4 organizations |
| I20240625004113 | HI | Practitioner - Nurse Practitioner | 1254747728 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95013139 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles (7 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Myndfull Care Management California PC | Current |
Accepting new patients | |
| KNH Advanced Practice Nursing Inc. | Current |
Accepting new patients | |
| California Care Wellness Medical Center Inc. | Current |
Accepting new patients | |
| Aloha Mental Wellness LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Geri Connection | Current |
Accepting new patients | |
| Grow Healthcare Group PA | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
15644 Pomerado Rd
Ste 202
Poway, CA 92064
Phone (619) 320-8090
8445 Camino Santa Fe
Ste 215
San Diego, CA 92121
Phone (619) 541-3246
6280 Jackson Dr
Ste 8
San Diego, CA 92119
Phone (619) 464-1607
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
1050 Queen St
Ste 100
Honolulu, HI 96814
Phone (808) 207-5887
500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490
928 Nuuanu Ave
Ste LL2
Honolulu, HI 96817
Phone (808) 276-0092
9436 W Lake Mead Blvd
Ste 5
Las Vegas, NV 89134
Phone (702) 328-7648
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- keena.harrison.p1@direct.chsica.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95013139 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95013139 | CA | Yes |
Addresses
Primary practice location
7065 Indiana Ave Ste 110
Riverside, CA 92506-4167
Mailing address
19637 Mariposa Ave
Riverside, CA 92508-9634
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://savashealth.com/ | Direct |
Other providers in Riverside, CA
- Shea Harris
- Christine Harrison
- Jaden Harrison
- Jocelyn Harrison
- Kaylin Harrison
- Linda E Harrison
- Myra Agnes Harrison
- Sara Harrison
- Skyler Harrison
- Ashley Hart
All providers in Riverside, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.