Tizi K Fobanjong, PMHNP
Nurse Practitioner, Psych/Mental Health in Worcester, Massachusetts
1790517472- Practice location
- 100 Grove St Ste 203, Worcester, MA 01605-2630
- Phone
- 508-250-8378
- Fax
- —
- Last updated
- August 11, 2026
Tizi K Fobanjong is a Nurse Practitioner, Psych/Mental Health based in Worcester, MA. Tizi K Fobanjong practices in Worcester, MA and has the professional credentials of PMHNP. The NPI Number for Tizi K Fobanjong is 1790517472 and holds a License No. 2023191216 (MA). The current practice location address for Tizi K Fobanjong is 100 Grove St Ste 203, Worcester, MA 01605-2630 and can be reached out via phone at 508-250-8378.
Provider Profile Details
- NPI Number
- 1790517472
- Provider Name
- Tizi K Fobanjong
- Credential
- PMHNP
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 100 Grove St Ste 203, Worcester, MA 01605-2630
- Phone Number
- 508-250-8378
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 20, 2024
- Last Update Date
- August 11, 2026
- Certification Date
- August 11, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 100 Grove St Ste 203
Worcester, MA 01605-2630 - City
- Worcester
- State
- Massachusetts
- Zip
- 01605-2630
- Phone Number
- 508-250-8378
Provider Business Mailing Address Details
- Address
- 960 Massachusetts Ave Ste 2
Boston, MA 02118-2690 - City
- Boston
- State
- MA
- Zip
- 02118-2690
License Information
- License Number (1)
- 2023191216
- License State (1)
- MA
- Taxonomy (1)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
- License Number (2)
- RN2342607
- License State (2)
- MA
- Taxonomy (2)
- Registered Nurse, Psych/Mental Health · 163WP0808X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Tizi K Fobanjong, PMHNP?
The NPI number of Tizi K Fobanjong, PMHNP is 1790517472. It was assigned on August 20, 2024 and is currently active in the NPPES registry.
What is the specialty of Tizi K Fobanjong, PMHNP?
Tizi K Fobanjong, PMHNP is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in MA under license number 2023191216.
Where does Tizi K Fobanjong, PMHNP practice?
The practice location is 100 Grove St Ste 203, Worcester, MA 01605-2630. The office can be reached at 508-250-8378 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1790517472 directly on the NPPES registry website.