Individual provider Active NPI

Yata Haja Bazzie, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clinton, MD
National Provider Identifier
1043888779
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN199031 Issued in MD
Practice address
9409 Stream Valley LN
Clinton, MD 20735-1924
Phone
(240) 475-4161
Fax
(240) 318-2001
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN199031 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN199031 MD Primary

Addresses

Primary practice location

9409 Stream Valley LN
Clinton, MD 20735-1924

Mailing address

9409 Stream Valley LN
Clinton, MD 20735-1924
Phone (240) 475-4161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN199031MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Haja Behavioral and Medical Health Services LLC PastSince Jun 22, 2021 Accepting new patients
Haja Behavioral and Medical Health Services LLC PastSince Jun 22, 2021 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1043888779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9409 STREAM VALLEY LN",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351924",
            "telephone_number": "240-475-4161",
            "fax_number": "240-318-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 STREAM VALLEY LN",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351924",
            "telephone_number": "240-475-4161",
            "fax_number": "240-318-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZIE",
        "first_name": "YATA",
        "middle_name": "HAJA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "RN199031",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "RN199031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.