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General NPI Number Information
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NPI Number | 1609667443
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Entity Type | Organization
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Legal Business Name | DEMAVIE BEHAVIORAL AND MENTAL WELLNESS SERVICES, INC.
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 3972 BARBURY PALMS WAY
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City | PERRIS
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State | CA
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Zip | 92571-7473
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Country | US
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Telephone | 703-896-6603
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Fax |
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Provider Business Mailing Address
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Address Line | 3870 LA SIERRA AVE # 2033
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City | RIVERSIDE
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State | CA
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Zip | 92505-3528
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Country | US
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Telephone | 833-667-0006
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | EKUA AMOKWANOA BAIDEN SOKOYA
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Credential | DNP, FNP, PMHNP-BC
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Telephone | 703-896-6603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 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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