Healthcare Provider Details

I. General information

NPI: 1659919223
Provider Name (Legal Business Name): SAZIA MALEK FNP-C, PMHNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2019
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 E GRAND AVE
EL SEGUNDO CA
90245-3947
US

IV. Provider business mailing address

431 E GRAND AVE
EL SEGUNDO CA
90245-3947
US

V. Phone/Fax

Practice location:
  • Phone: 310-806-3069
  • Fax:
Mailing address:
  • Phone: 310-806-3069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95013187
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95013187
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: