Individual provider Active NPI

Bamidele Ojo-Fati

  • Psychiatric/Mental Health Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1619635893
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95030424 Issued in CA
Practice address
1203 Willow Hill Ave
Sacramento, CA 95834-1679
Phone
(612) 325-3999
NPI assigned
Dec 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95030424 CA Primary

Addresses

Primary practice location

1203 Willow Hill Ave
Sacramento, CA 95834-1679

Mailing address

1203 Willow Hill Ave
Sacramento, CA 95834-1679
Phone (612) 325-3999

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
I20250605001293 CA Practitioner - Nurse Practitioner 7113436528 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95206893CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Apr 30, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1619635893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 WILLOW HILL AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341679",
            "telephone_number": "612-325-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 WILLOW HILL AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341679",
            "telephone_number": "612-325-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJO-FATI",
        "first_name": "BAMIDELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95030424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.