Organization · Type 2 NPI

Bubblegum and Duct Tape Psychiatry, P.c.

Psychiatric/Mental Health Nurse Practitioner · Sacramento, CA

NPI number 1629959150 Active

Practice location

180 Promenade Cir Ste 300
Sacramento, CA 95834-2952

Fax (916) 404-0477

Other practice locations

  • 4660 NE Belknap Ct, Hillsboro, OR 97124-6467 · (844) 966-5349

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNone listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

21 other providers at this address

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About NPI 1629959150

Bubblegum and Duct Tape Psychiatry, P.c.'s National Provider Identifier is 1629959150, issued on Sep 10, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Sacramento, CA. The record was last updated on Oct 28, 2026.