Provider Demographics
NPI:1083446074
Name:AZIZ, ABBIEBATU (NP)
Entity type:Individual
Prefix:
First Name:ABBIEBATU
Middle Name:
Last Name:AZIZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 SOUTH SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 110 #1018
Mailing Address - City:WESTCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:90045
Mailing Address - Country:US
Mailing Address - Phone:909-573-7183
Mailing Address - Fax:
Practice Address - Street 1:8939 SOUTH SEPULVEDA BLVD
Practice Address - Street 2:SUITE 110 #1018
Practice Address - City:WESTCHESTER
Practice Address - State:CA
Practice Address - Zip Code:90045
Practice Address - Country:US
Practice Address - Phone:909-573-7183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031644363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health