| NPI | 1033072509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIDELIS EKATA AZEKE Chief Executive Officer 916-895-6095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2025-12-03 |
| Last Update Date | 2026-04-06 |