Organization
SAN INTEGRATIVE PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FASILAT OLASUMBO PMHNP (NURSE PRACTITIONER)
(720) 309-3712
Entity
Organization
Contact information
Practice address
1685 EATON ST, LAKEWOOD, CO 80214-1628
(303) 304-5795
Mailing address
1685 EATON ST, LAKEWOOD, CO 80214-1628
(303) 304-5795
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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