Healthcare Provider Details

I. General information

NPI: 1144929647
Provider Name (Legal Business Name): TOIMBIE SIH AMAAZEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15807 BRIGHTON AVE APT 1
GARDENA CA
90247-3970
US

IV. Provider business mailing address

15807 BRIGHTON AVE APT 1
GARDENA CA
90247-3970
US

V. Phone/Fax

Practice location:
  • Phone: 310-800-5248
  • Fax:
Mailing address:
  • Phone: 310-800-5248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95024369
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number95024369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: