Healthcare Provider Details

I. General information

NPI: 1225945942
Provider Name (Legal Business Name): NOVA HEALTH INTEGRATED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7193 E BOBWHITE CT
SAN TAN VALLEY AZ
85143-1222
US

IV. Provider business mailing address

7193 E BOBWHITE CT
SAN TAN VALLEY AZ
85143-1222
US

V. Phone/Fax

Practice location:
  • Phone: 714-676-6045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NICHOLUS KALOKI
Title or Position: PMHNP
Credential:
Phone: 714-676-6045