Prince Akuamoah Asante
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · San Pedro, CA
NPI 1992568166 · NPPES record last updated Jan 31, 2024
Key facts
- NPI
- 1992568166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 95028907 (CA)
- Practice address
- 1386 W 7TH St
San Pedro, CA 90732-3517 - Phone
- (310) 241-4330
- NPI assigned
- Jan 31, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241125001044 | CA | Order and Referring Only - Nurse Practitioner | 6901331149 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95028907 | CA | Yes |
Addresses
Primary practice location
1386 W 7TH St
San Pedro, CA 90732-3517
Mailing address
1386 W 7TH St
San Pedro, CA 90732-3517
Phone (714) 618-3378
Other providers in San Pedro, CA
- Arlyn Inc
- Felicia Arteaga
- Artemis Center for Family, a Professional Corporation
- Arthur G Kaiser DDS Inc
- Dolores Isabela Arviso
- Kari Ashcroft
- Brittany Doryce Ashe
- Nina Ashrafzadeh
- Asghar Askari
- Assistance League of San Pedro-South Bay
All providers in San Pedro, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.