Healthcare Provider Details

I. General information

NPI: 1326590688
Provider Name (Legal Business Name): ALYSHA SWAIM AZIZ RN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1563
US

IV. Provider business mailing address

3521 TEELING CT
CASTRO VALLEY CA
94546-3582
US

V. Phone/Fax

Practice location:
  • Phone: 510-415-8857
  • Fax:
Mailing address:
  • Phone: 510-415-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95109023
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95035693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: