Healthcare Provider Details

I. General information

NPI: 1033072509
Provider Name (Legal Business Name): AFFIRM PSYCHIATRIC NURSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 K ST STE 529
SACRAMENTO CA
95814-3418
US

IV. Provider business mailing address

8593 CAMILLA CT
ELK GROVE CA
95757-6405
US

V. Phone/Fax

Practice location:
  • Phone: 916-895-6095
  • Fax:
Mailing address:
  • Phone: 916-895-6095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. FIDELIS EKATA AZEKE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PMHNP-BC
Phone: 916-895-6095