MEDICARE: JAMILA FAIQ M.S.N-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	163W00000X	Registered Nurse	781318	CA
2	363LF0000X	Family Nurse Practitioner	95004759	CA
3	363L00000X	Nurse Practitioner	95004759	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95004759	OTHER	CA	CA MEDICAL LICENSE

General Provider Information

NPI Number	:	1518414366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMILA FAIQ M.S.N-BC

Provider Business Mailing Address
First Line	:	PO BOX 25100
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-5100
Country	:	US
Telephone Number	:	559-326-1222
Fax Number	:	559-421-7004

Provider Business Practice Location Address
First Line	:	28078 BAXTER RD STE 140
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-1403
Country	:	US
Telephone Number	:	760-733-9191
Fax Number	:	760-733-9192

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

Provider Enumeration Date	:	09/08/2016
Last Update Date	:	02/03/2026

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Directions to “ JAMILA FAIQ M.S.N-BC” Practice Location

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