Individual provider · Type 1 NPI
Mary J. Tichacek, RN, PMHNP-BC, PMHCNS
Psychiatric/Mental Health Nurse Practitioner · San Diego, CA
NPI number
1841836244
Active
Practice location
11515 El Camino Real Ste 100
San Diego, CA 92130-3034
Other practice locations
- 2417 Marshall Ave Ste 1, Imperial, CA 92251-9401 · (858) 245-1195
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 202048 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95024198 (CA) |
| Clinical Nurse Specialist | 364S00000X | 207 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1841836244
Mary J. Tichacek, RN, PMHNP-BC, PMHCNS's National Provider Identifier is 1841836244, issued on Nov 20, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in San Diego, CA. The record was last updated on Oct 29, 2025.