Sunny Makolo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

844501 Issued in TX

Practice address

1225 W 190TH St Ste 280
Gardena, CA 90248-4305

Phone

(877) 515-8113

NPI assigned

Sep 24, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, CA, AZ3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713

  AZ, TX

  Medicare reassignment
• Fernando M. Siles, MD, PLLC

  • Child & Adolescent Psychiatry Physician
  • Greenville, TX
  • NPI 1225377328
  NPD
• Julia Larsen PLCC, Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Farmersville, TX
  • NPI 1417598673
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1003467879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W UNION HILLS DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850275163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 280",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484305",
            "telephone_number": "877-515-8113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 W Union Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850275163",
            "country_code": "US",
            "telephone_number": "480-424-5228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2405 Stonewall St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "TX",
            "postal_code": "754013349",
            "country_code": "US",
            "telephone_number": "903-454-3300",
            "fax_number": "903-454-3307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKOLO",
        "first_name": "SUNNY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "250872",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "844501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer NA T Mai, DDS
• Breanne Mailhot, BCBA
• Luis Maimoni
• Nikita Mainaly, PHARMD
• Making Fit Fun, Inc.
• Kira Makuta, OTR/L
• Maria Guadalupe Maldonado - Penaloza
• Rosa Maldonado Anica
• Carmen Maldonado, NONE
• Gianna Patricia Marvilla Maldonado

• Psychiatric/Mental Health Nurse Practitioner in Gardena, CA
• Providers in Gardena, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.