Farooque Azam
Nurse Practitioner - Psych/Mental Health
12450 Van Nuys Blvd Ste 200, Pacoima
California, 91331-1393
818-896-1161
Farooque Azam is a Pacoima, California based nurse practitioner who is specialized as Psych/Mental Health nurse. Active license number of Farooque Azam is 95014104 for Psych/Mental Health in California. His current practice location is 12450 Van Nuys Blvd Ste 200, Pacoima. Patients can reach him at 818-896-1161 or can fax him at 818-896-5069 with specialization in Psych/Mental Health and his NPI number (Unique professional ID assigned by NPPES) is 1689203093.
Farooque Azam provides a full range of primary mental health care services, including biopsychosocial assessment and diagnosis of patients with mental illness and co-occurring disorders. Treatment modalities include both medication and psychotherapeutic management. Psych/Mental Health Nurse Practitioner (PMHNP) works in a variety of settings, including inpatient, emergency and community-based mental health services.
Complete Profile:
Farooque Azam speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Farooque Azam |
| Specialization: | Psych/Mental Health Nurse Practitioner (PMHNP) |
| Gender: | Male |
| Practice Address: | 12450 Van Nuys Blvd Ste 200, Pacoima,
California, 91331-1393 |
| Phone: | 818-896-1161 |
| Fax: | 818-896-5069 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1689203093 |
| NPI Enumeration Date: | 07 Apr, 2020 |
| NPI Last Update On: | 10 Apr, 2023 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Farooque Azam are as mentioned below.
| License Number | Specialization | State | Status | |
| 95014104 | Psych/Mental Health | California | Primary | |
| 65014104 | Psych/Mental Health | California | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Farooque Azam such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 6758 | Medicaid | California | |
| 7420 | Medicaid | California | |
| 7068 | Medicaid | California | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Farooque Azam
12450 Van Nuys Blvd Ste 200,
Pacoima, California |
| Zip: | 91331-1393 |
| Phone Number: | 818-896-1161 |
| Fax Number: | 818-896-5069 |
Patients can reach Farooque Azam at
12450 Van Nuys Blvd Ste 200, Pacoima, California or can
call to book an appointment on 818-896-1161.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.