Provider Demographics
NPI:1225929797
Name:INVICTUS INTEGRATIVE PSYCHIATRY, A PROFESSIONAL NURSING CORPORATION
Entity type:Organization
Organization Name:INVICTUS INTEGRATIVE PSYCHIATRY, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSAS-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:323-706-4653
Mailing Address - Street 1:16888 NISQUALLI RD STE 200-5
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-9703
Mailing Address - Country:US
Mailing Address - Phone:323-706-4653
Mailing Address - Fax:
Practice Address - Street 1:16888 NISQUALLI RD STE 200-5
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-9703
Practice Address - Country:US
Practice Address - Phone:323-706-4653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty