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General NPI Number Information
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NPI Number | 1518648286
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Entity Type | Organization
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Legal Business Name | FAJUZ PSYCHIATRY ASSOCIATES LLC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 18411 CRENSHAW BLVD STE 210
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City | TORRANCE
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State | CA
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Zip | 90504-5048
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Country | US
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Telephone | 213-448-4267
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Fax |
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Provider Business Mailing Address
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Address Line | 945 E MEADBROOK ST
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City | CARSON
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State | CA
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Zip | 90746-1631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN AUDU
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Credential | DNP
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Telephone | 213-448-4267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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