Individual provider Active NPI

Toimbie Sih Amaazee

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1144929647
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95024369 Issued in CA
Practice address
15807 Brighton Ave Apt 1
Gardena, CA 90247-3970
Phone
(310) 800-5248
NPI assigned
Feb 23, 2023
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95024369 CA Primary
Community Psychiatric/Mental Health Clinical Nurse Specialist 364SP0812X 95024369 CA

Addresses

Primary practice location

15807 Brighton Ave Apt 1
Gardena, CA 90247-3970

Mailing address

15807 Brighton Ave Apt 1
Gardena, CA 90247-3970
Phone (310) 800-5248

Other practice location 1

1225 W 190th St Ste 280
Gardena, CA 90248-4305
Phone (310) 515-8113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230530002340 CA Practitioner - Nurse Practitioner 0648637041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

2880 Zanker Rd
Suite 203
San Jose, CA 95134-2122
Phone (877) 515-8113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95024369CAMDCommunity Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. CurrentSince May 25, 2023 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

2880 Zanker Rd
Ste 203
San Jose, CA 95134
Phone (408) 354-6783

14541 Delano St
Van Nuys, CA 91411
Phone (310) 515-8113

Organizations & group practices 1

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": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1144929647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15807 BRIGHTON AVE APT 1",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473970",
            "telephone_number": "310-800-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15807 BRIGHTON AVE APT 1",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473970",
            "telephone_number": "310-800-5248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 W 190th St Ste 280",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484305",
            "country_code": "US",
            "telephone_number": "310-515-8113",
            "fax_number": "310-538-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMAAZEE",
        "first_name": "TOIMBIE",
        "middle_name": "SIH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95024369",
            "primary": true
        },
        {
            "code": "364SP0812X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Community",
            "state": "CA",
            "license": "95024369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.