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General NPI Number Information
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NPI Number | 1033072509
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Entity Type | Organization
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Legal Business Name | AFFIRM PSYCHIATRIC NURSING INC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 9245 LAGUNA SPRINGS DR STE 200
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City | ELK GROVE
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State | CA
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Zip | 95758-7991
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Country | US
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Telephone | 916-895-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 8593 CAMILLA CT
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City | ELK GROVE
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State | CA
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Zip | 95757-6405
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Country | US
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Telephone | 916-895-6095
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. FIDELIS EKATA AZEKE
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Credential | PMHNP-BC
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Telephone | 916-895-6095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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