Healthcare Provider Details

I. General information

NPI: 1487109955
Provider Name (Legal Business Name): ESOHE ABEL OMORUYI FNP-C, PMHNPBC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3946 NORWOOD AVE
SACRAMENTO CA
95838-3300
US

IV. Provider business mailing address

6950 SHADY LN
SCURRY TX
75158-2831
US

V. Phone/Fax

Practice location:
  • Phone: 916-564-0521
  • Fax:
Mailing address:
  • Phone: 214-283-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1140683
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95004512
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95004512
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1140683
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: