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NPI Code Detail

MEDICARE: AFFIRM PSYCHIATRIC NURSING

MEDICARE: AFFIRM PSYCHIATRIC NURSING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0807XChild & Adolescent Psychiatric/Mental Health Registered Nurse
2163WP0809XAdult Psychiatric/Mental Health Registered Nurse
3101YM0800XMental Health Counselor
4363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1033072509
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFIRM PSYCHIATRIC NURSING
Provider Business Mailing Address
First Line : 8593 CAMILLA CT
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-6405
Country : US
Telephone Number : 916-895-6095
Fax Number :
Provider Business Practice Location Address
First Line : 9245 LAGUNA SPRINGS DR STE 200
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-7991
Country : US
Telephone Number : 916-895-6095
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DR. FIDELIS EKATA AZEKE
Credential : PMHNP-BC
Telephone Number : 916-895-6095
Provider Enumeration Date : 12/03/2025
Last Update Date : 04/06/2026

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Directions to “AFFIRM PSYCHIATRIC NURSING ” Practice Location

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