Provider Demographics
NPI:1336886860
Name:INFINITE NURSING MEDICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:INFINITE NURSING MEDICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FOLASHADE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYEOBA-SAMPAY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP, DNP
Authorized Official - Phone:909-544-3851
Mailing Address - Street 1:7453 TUCSON LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0712
Mailing Address - Country:US
Mailing Address - Phone:909-544-3851
Mailing Address - Fax:
Practice Address - Street 1:7453 TUCSON LN
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-0712
Practice Address - Country:US
Practice Address - Phone:909-544-3851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty