Individual provider · Type 1 NPI

Farooque Azam

Psychiatric/Mental Health Nurse Practitioner · Pacoima, CA

NPI number 1689203093 Active

Practice location

12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331-1393

Fax (818) 896-5069

Other practice locations

  • 1225 W 190th St Ste 280, Gardena, CA 90248-4305 · (310) 515-8113

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X95014104 (CA)
Psychiatric/Mental Health Nurse Practitioner 363LP0808X65014104 (CA)

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

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About NPI 1689203093

Farooque Azam's National Provider Identifier is 1689203093, issued on Apr 7, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Pacoima, CA. The record was last updated on Apr 10, 2023.