MEDICARE: AOIFE O'SULLIVAN PMHNP-BC

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	95037439	CA

General Provider Information

NPI Number	:	1497615413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AOIFE O'SULLIVAN PMHNP-BC

Provider Business Mailing Address
First Line	:	4349 33RD PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92104-1404
Country	:	US
Telephone Number	:	774-722-1805
Fax Number	:

Provider Business Practice Location Address
First Line	:	4349 33RD PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92104-1404
Country	:	US
Telephone Number	:	774-722-1805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

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

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