Individual provider Active NPI

Maxine C Okafor, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1710404306
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
268777 Issued in AZ
Practice address
401 N Brand Blvd Ste 834
Glendale, CA 91203-4451
Phone
(323) 568-1700
Fax
(323) 568-1700
NPI assigned
Aug 24, 2017
Reactivated
Jun 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP134780 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95008984 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP134780 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 268777 AZ Primary

Addresses

Primary practice location

401 N Brand Blvd Ste 834
Glendale, CA 91203-4451

Mailing address

1902 W Union Hills Dr Unit 41331
Phoenix, AZ 85080-4115
Phone (323) 568-1700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181127002408 TX Practitioner - Nurse Practitioner 6103160411 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95008984CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Perfect Prescription Medical Services PC Psychiatric/Mental Health CurrentSince Dec 17, 2024 Accepting new patients
Rising Medical Group PLLC Past Accepting new patients

Locations

1902 W Union Hills Dr
Unit 41331
Phoenix, AZ 85080

401 N Brand Blvd
Ste 834
Glendale, CA 91203
Phone (818) 480-4829

2031 John West Rd
Ste 107
Dallas, TX 75228
Phone (323) 568-1700

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.maxineokafor@148377.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1710404306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 W UNION HILLS DR UNIT 41331",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850804115",
            "telephone_number": "323-568-1700",
            "fax_number": "323-568-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BRAND BLVD STE 834",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034451",
            "telephone_number": "323-568-1700",
            "fax_number": "323-568-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAFOR",
        "first_name": "MAXINE",
        "middle_name": "C",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "deactivation_date": "2025-05-07",
        "reactivation_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134780",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95008984",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP134780",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "268777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.