Healthcare Provider Details

I. General information

NPI: 1669153672
Provider Name (Legal Business Name): HALIMA NAMAKULA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 HOWE AVE STE 101
SACRAMENTO CA
95825-3364
US

IV. Provider business mailing address

1325 HOWE AVE STE 101
SACRAMENTO CA
95825-3364
US

V. Phone/Fax

Practice location:
  • Phone: 916-246-2979
  • Fax:
Mailing address:
  • Phone: 916-246-2979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95040898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: