Healthcare Provider Details

I. General information

NPI: 1700740404
Provider Name (Legal Business Name): ALDAR SELIMOVIC MSN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9047 POLLY AVE
ORANGEVALE CA
95662-4724
US

IV. Provider business mailing address

9047 POLLY AVE
ORANGEVALE CA
95662-4724
US

V. Phone/Fax

Practice location:
  • Phone: 954-706-3203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95037859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: