Oluwatosin Fakorede

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1094804 Issued in TX

Practice address

6609 Blanco Rd
San Antonio, TX 78216-6152

Phone

(210) 940-2764

NPI assigned

Jan 16, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Alamo Premier Mental Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
  • NPI 1124626114
  Medicare reassignment NPD

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

{
    "created_epoch": "1768521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1497614481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 HAMRICK CIR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782522885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166152",
            "telephone_number": "210-940-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKOREDE",
        "first_name": "OLUWATOSIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-16",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1094804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maribel Fajardo Garcia
• Gabriela Cristina Fajardo, PA
• Ashlynn-Joy P Fajayan
• Mohamad Hassan Fakhreddine, M.D.
• Christiana T Fakhri, MD
• Kamran Falahati
• Crystal Falco, NP-C
• Gabrielle Marie Falco, MD
• Ramon Lazaro Falcon Martinez Sr.
• Maria G. Falcon-Cantrill, MD

• Psychiatric/Mental Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.