Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Farooque Azam

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1689203093

Farooque Azam is a Nurse Practitioner in Pacoima, California. Qualified in 2019, 7 years ago. Practices with Sokyahealth Medical Group PC, a 178-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331-1393
Phone: (818) 896-1161
Fax: (818) 896-5069
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1225 W 190th St Ste 280, Gardena, CA 90248-4305 — (310) 515-8113

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95014104 (CA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 65014104 (CA)

Record details

NPI number1689203093
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 7, 2020
Last updated in NPPESApril 10, 2023
Certification dateApril 10, 2023
Mailing address12450 Van Nuys Blvd Ste 200, Pacoima, CA 91331-1393

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Sokyahealth Medical Group Pc — 178 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Pacoima