Healthcare Provider Details

I. General information

NPI: 1043913221
Provider Name (Legal Business Name): RAHEEMAT ADAMSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1774 ZONAL AVE # RTP-D
LOS ANGELES CA
90033-1063
US

IV. Provider business mailing address

1774 ZONAL AVE # RTP-D
LOS ANGELES CA
90033-1063
US

V. Phone/Fax

Practice location:
  • Phone: 562-864-7821
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1111240
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95245574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: