PACIFIC KETAMINE AND WELLNESS, A PROFESSIONAL NURSING CORPORATION
NPI 1629882956
Clinic/Center - Mental Health (Including Community Mental Health Center) in Santa Cruz, CA
About Pacific Ketamine And Wellness, A Professional Nursing Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PACIFIC KETAMINE AND WELLNESS, A PROFESSIONAL NURSING CORPORATION (NPI 1629882956) is a healthcare organization registered as a mental health (including community mental health center) in Santa Cruz, California and active in the NPI registry since February 2025. The organization lists Jaime Jimenez, Owner/nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pacific Ketamine And Wellness, A Professional Nursing Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Pacific Ketamine And Wellness, A Professional Nursing Corporation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Pacific Ketamine And Wellness, A Professional Nursing Corporation's NPI number?
The NPI number for Pacific Ketamine And Wellness, A Professional Nursing Corporation is 1629882956. It was assigned to this organization in the NPPES registry on February 6, 2025.
Where is Pacific Ketamine And Wellness, A Professional Nursing Corporation located?
Pacific Ketamine And Wellness, A Professional Nursing Corporation is located at 412 Cedar St Ste C2, Santa Cruz, CA 95060. The listed phone number is (831) 824-4003.
What is Pacific Ketamine And Wellness, A Professional Nursing Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Pacific Ketamine And Wellness, A Professional Nursing Corporation enrolled in Medicare?
Yes. Pacific Ketamine And Wellness, A Professional Nursing Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pacific Ketamine And Wellness, A Professional Nursing Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Pacific Ketamine And Wellness, A Professional Nursing Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Pacific Ketamine And Wellness, A Professional Nursing Corporation was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Pacific Ketamine And Wellness, A Professional Nursing Corporation · NPI 1629882956
Mental Health (Including Community Mental Health Center) organization in Santa Cruz, California. Organization record, active in the CMS NPPES registry since February 6, 2025.
## Identity
- **NPI:** 1629882956 (Entity type: Organization)
- **Enumerated:** February 6, 2025
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Jaime Jimenez, OWNER/NURSE PRACTITIONER
## Practice location
- **Address:** 412 CEDAR ST STE C2, Santa Cruz, CA 95060-4369
- **Phone:** (831) 824-4003
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 27, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1629882956) · Data from the CMS NPPES public registry.