Healthcare Provider Details

I. General information

NPI: 1083345367
Provider Name (Legal Business Name): AQSA ZIA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2022
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 CONCORD AVE
CHICO CA
95928-9208
US

IV. Provider business mailing address

1811 CONCORD AVE
CHICO CA
95928-9208
US

V. Phone/Fax

Practice location:
  • Phone: 530-487-7061
  • Fax: 530-487-7061
Mailing address:
  • Phone: 530-487-7061
  • Fax: 530-487-7061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95189135
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95021566
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: