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General NPI Number Information
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NPI Number | 1992625735
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Entity Type | Organization
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Legal Business Name | ASILI INSTITUTE FOR WOMEN'S BRAIN HEALTH, TRAUMA & RECOVERY
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 558 B ST
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City | SANTA ROSA
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State | CA
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Zip | 95401-5240
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Country | US
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Telephone | 916-842-8310
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11643
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City | SANTA ROSA
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State | CA
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Zip | 95406-1643
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Country | US
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Telephone | 916-842-8310
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MS. SELAMAWIT T GEBREZGHI
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Credential | FNP-C, PMHNP-BC
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Telephone | 916-842-8310
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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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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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