NPIMap

Individual provider Active NPI

Emmanuel Ifemazi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1558052159
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95025107 Issued in CA
Practice address
1225 W 190TH St Ste 280
Gardena, CA 90248-4305
Phone
(877) 515-8113
NPI assigned
May 16, 2023
Sex
Male
Sole proprietor
Yes

Organizations & group practices 7

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Coast Behavioral Health Inc 14 clinicians

Practice addresses (Care Compare)

4024 Rosemead Blvd
Pico Rivera, CA 90660-1774
Phone (747) 242-4186

536 Camino Mercado
Arroyo Grande, CA 93420-1814
Phone (805) 540-0279

Hospital & facility affiliations

  • Neighbor Care Home Health Home health agency, Westlake Village, CA, CCN 059450
  • Excellent in-Home Care, Inc Home health agency, Woodland Hills, CA, CCN 058000
  • Mission Home Health of Ventura, LLC Home health agency, Oxnard, CA, CCN 557219
  • Hearten Home Health Inc Home health agency, Simi Valley, CA, CCN 059088
  • Home Health 4U, Inc Home health agency, Granada Hills, CA, CCN 059031
  • Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394
  • Community Memorial Hospital - Ojai Hospital, Ojai, CA, CCN 051334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106002130 CA Practitioner - Nurse Practitioner 0143677682 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Doc Integrated Med, PC CurrentSince Jul 19, 2025 Accepting new patients
Palm Desert Psychiatry Inc CurrentSince Feb 7, 2025 Accepting new patients
Central Coast Behavioral Health, Inc. Psychiatric/Mental Health CurrentSince Feb 7, 2025 Accepting new patients
Clarity Mental Wellness Inc Psychiatric/Mental Health CurrentSince Jul 30, 2025 Accepting new patients
J M Geiss DO Apc CurrentSince Jul 19, 2025 Accepting new patients
Ruby Technology Services LLC Past Accepting new patients

Locations

536 Camino Mercado
Arroyo Grande, CA 93420
Phone (346) 502-3707

353 E Park Ave
El Cajon, CA 92020
Phone (323) 893-5844

7067 N Mariposa St
Ste 103
Fresno, CA 93720
Phone (559) 380-4304

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

74075 El Paseo
Ste A16
Palm Desert, CA 92260

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

26893 Bouquet Rd
#C201
Saugus, CA 91350
Phone (818) 852-9320

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95025107 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

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

Mailing address

1225 W 190TH St Ste 280
Gardena, CA 90248-4305
Phone (877) 515-8113

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2024.

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1558052159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 280",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484305",
            "telephone_number": "877-515-8113"
        },
        {
            "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": [],
    "basic": {
        "last_name": "IFEMAZI",
        "first_name": "EMMANUEL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-16",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.