Provider Demographics
NPI:1487021911
Name:COAXUM, SALEMA (DNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:SALEMA
Middle Name:
Last Name:COAXUM
Suffix:
Gender:F
Credentials:DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15615 ALTON PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7308
Mailing Address - Country:US
Mailing Address - Phone:888-588-8995
Mailing Address - Fax:
Practice Address - Street 1:15615 ALTON PKWY STE 250
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7308
Practice Address - Country:US
Practice Address - Phone:888-588-8995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN200458163W00000X
CORXN.0106832-NP363LP0808X
COC-APN.0001398-C-NP363LP0808X
NC5011616363LP0808X
NV826486363LP0808X
COAPN.0997838-NP363LP0808X
CA95024000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse