MEDICARE: OASIS OF WELLNESS MENTAL HEALTH NURSING CORPORATION

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1043004476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS OF WELLNESS MENTAL HEALTH NURSING CORPORATION

Provider Business Mailing Address
First Line	:	8484 ELDER CREEK RD STE 101
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-1799
Country	:	US
Telephone Number	:	916-250-3492
Fax Number	:

Provider Business Practice Location Address
First Line	:	8484 ELDER CREEK RD STE 101
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-1799
Country	:	US
Telephone Number	:	916-250-3492
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FUNMILAYO IGBINIGIE
Credential	:
Telephone Number	:	469-638-3162

Provider Enumeration Date	:	04/09/2025
Last Update Date	:	12/11/2025

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