Provider Demographics
NPI:1912863523
Name:TRINITY HOLISTIC PSYCHIATRY A PROFESSIONAL NURSING CORPORATION
Entity type:Organization
Organization Name:TRINITY HOLISTIC PSYCHIATRY A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:PMNHP-BC
Authorized Official - Phone:916-610-9401
Mailing Address - Street 1:717 K ST STE 425
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-3477
Mailing Address - Country:US
Mailing Address - Phone:916-610-9401
Mailing Address - Fax:
Practice Address - Street 1:717 K ST STE 425
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-3477
Practice Address - Country:US
Practice Address - Phone:916-610-9401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-27
Last Update Date:2025-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)