{"npi":"1689203093","type":"NPI-1","status":"active","name":{"display":"Farooque Azam","other":[{"code":"2","type":"Professional name","value":"AZAM, FAROOQUE"}],"first":"FAROOQUE","last":"AZAM"},"specialty":{"primary_taxonomy":"363LP0808X","primary_taxonomy_description":"Psychiatric/Mental Health Nurse Practitioner","slug":"psychiatric-mental-health-nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363LP0808X","description":"Psychiatric/Mental Health Nurse Practitioner","primary":true,"state":"CA","license":"95014104"},{"code":"363LP0808X","description":"Psychiatric/Mental Health Nurse Practitioner","primary":false,"state":"CA","license":"65014104"}]},"addresses":[{"purpose":"LOCATION","street_1":"12450 VAN NUYS BLVD STE 200","city":"PACOIMA","state":"CA","postal_code":"913311393","country_code":"US","phone":"8188961161","fax":"8188965069"},{"purpose":"MAILING","street_1":"12450 VAN NUYS BLVD STE 200","city":"PACOIMA","state":"CA","postal_code":"913311393","country_code":"US","phone":"8188961161","fax":"8188965069"}],"license":{"state":"CA","number":"95014104"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"6758","state":"CA","issuer":null},{"type_code":"05","label":"Medicaid","value":"7420","state":"CA","issuer":null},{"type_code":"05","label":"Medicaid","value":"7068","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20200904001152","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"CA","pac_id":"0941627988"}]},"enumeration_date":"2020-04-07","last_updated":"2023-04-10","_meta":{"source":"NPPES","snapshot_date":"2023-04-10","doc_url":"https://findmynpi.com/api"}}