- 21297 Foothill Blvd, Ste 203 Hayward, CA 94541
- (415) 636-9700
- hello@exxceedwellness.com
In-person & telehealth across California
Patient reviews
"I had a great experience with Nef — she listened to me and made treatment recommendations straight away. I'd recommend her to anyone."
"I love the team. They're very responsive and helpful. Nef is amazing, and my transition to their office has been great."
"Very smooth and seamless process while in a distressing situation. I appreciate their team very much."
"Great provider — really listens, one of the few who seems to genuinely care. Would recommend to any of my friends or family."
Rating and review count reflect this provider's live Zocdoc profile.
Meet your care team
Board-certified PMHNP and attorney with twenty years of clinical training, including interventional psychiatry. She founded Exxceed Wellness to bring advanced, evidence-based care — including TMS and Spravato — to people who haven't found relief through standard treatment.
Board-certified psychiatric-mental health nurse practitioner with nearly a decade of experience across outpatient care, crisis stabilization, and community mental health. She provides both psychotherapy and medication management, caring for adolescents and adults through anxiety, depression, and trauma with evidence-based methods like CBT, mindfulness, and motivational interviewing.
A licensed psychiatrist (MD) who serves as our collaborating physician.
When first-line treatment isn't enough
Alongside everyday psychiatric care, we offer advanced, evidence-based options for when therapy and medication haven't been enough — including two interventional treatments most local clinics don't provide.
Non-invasive, FDA-cleared brain stimulation for depression, OCD, and anxiety that hasn't responded to medication. Standard, iTBS/Express, and Deep TMS.
Learn more →In-office, REMS-certified, FDA-approved nasal spray for treatment-resistant depression — given under monitoring. Not IV or compounded ketamine.
Learn more →Careful, ongoing psychiatric prescribing tailored to your response over time — on its own or alongside TMS or Spravato.
Learn more →Evidence-based psychotherapy — CBT, mindfulness, and more — on its own or combined with medication for lasting change.
Learn more →Your treatment path
Care isn't one straight line. Here's how the path branches — and when first-line treatment isn't enough, what your options are.
We provide medication management, therapy, TMS, and Spravato in-house, and refer out for the rest. Which options fit depends on your diagnosis — TMS and Spravato are FDA-cleared for depression, while treatment-resistant anxiety is treated mainly with medication and therapy strategies. Candidacy is always determined clinically.
Conditions
We care for the full range of psychiatric conditions — with particular focus and depth in treatment-resistant depression, treatment-resistant anxiety, depression, anxiety, and ADHD. Every condition gets evidence-based care.
Depression that hasn't responded to two or more treatments — where TMS and Spravato can help.
Evidence-based medication and therapy for generalized, social, and panic-related anxiety — including anxiety that hasn't responded to first-line treatment.
Medication management and therapy for major depressive disorder.
Comprehensive evaluation and ongoing management for adults and adolescents.
Medication, referral to ERP therapy, and Deep TMS for OCD that hasn't responded.
Trauma-informed treatment for post-traumatic stress.
Diagnostic clarity and mood-stabilizing medication management.
We treat the full range of psychiatric conditions — if you're struggling, reach out and we'll help or connect you to the right care.
Not responding to the first treatment — or the second — is more common than people think. We'll help you find what actually fits.
Who am I
"Within the depths of my ADHD lies a Hidden Power, unlocking the extraordinary potential… nurturing the inner flame, transcending perceived limitations, and defying expectations while inspiring others along the journey of self-discovery."
I am a board-certified Psychiatric Mental Health Nurse Practitioner, licensed in California to diagnose psychiatric-mental health conditions, prescribe medications, and provide psychotherapy. I earned my Bachelor of Science in Nursing and Juris Doctor from the University of Santo Tomas, and my advanced practice degree from Walden University.
Since 2004, I have worked extensively across inpatient acute care and behavioral psychiatric units — adolescents, acute adults, geriatric med-psych, and psychiatric intensive care — centered on the significantly impacted, underserved population. I specialize in depression, anxiety, substance use, and ADHD, grounded in a harm-reduction, trauma-informed, whole-person model. The care I render is always client-centered and non-judgmental.
Pronouns: she/her
Answers to common questions about psychiatric consultation, TMS therapy, Spravato (esketamine), and treatment-resistant depression at Exxceed Wellness in Hayward, CA. This is general education, not medical advice for your specific situation. If your question isn't answered here, please contact us.
We provide psychiatric care for depression and treatment-resistant depression, anxiety, OCD, and ADHD. Alongside medication management, we offer two interventional treatments, TMS and Spravato (esketamine), for depression that hasn't responded to standard care.
Your initial visit is a thorough evaluation. We review your history, current symptoms, past treatments, and goals, then discuss the options that fit your situation and build a treatment plan together. It is a conversation, not a quick screening.
Both. Our clinic is at 21297 Foothill Blvd, Ste 203, Hayward, CA, where in-office treatments such as TMS and Spravato are provided. We also see patients by secure telehealth across California for services that can be delivered remotely, including consultations and medication management.
Yes. Starting, adjusting, and monitoring psychiatric medications is a core part of our care - on its own or alongside TMS or Spravato.
No. You can schedule directly with our practice. A referral from another provider is welcome but not required.
Transcranial magnetic stimulation (TMS) uses focused magnetic pulses to stimulate the brain regions involved in mood regulation. It is non-invasive, medication-free, and done in the office. TMS is FDA-cleared for major depression (including treatment-resistant depression), anxious depression, and — as an adjunct — OCD; our Magstim Horizon 3.0 carries these clearances.
Most patients describe TMS as a tapping or knocking sensation on the scalp rather than pain; mild scalp discomfort is the most common side effect. A typical course is five sessions per week for about six weeks (roughly 30 to 36 sessions), followed by an individualized taper.
Active treatment can run from about 3 minutes with newer theta-burst (iTBS / Express) protocols to roughly 20 to 40 minutes for standard protocols. With check-in and setup, plan for a short in-office visit each time.
Standard rTMS uses a figure-8 coil to target a focused area. iTBS, or theta-burst, is a faster stimulation pattern that delivers treatment in just a few minutes. We match the protocol to your diagnosis and coverage.
TMS is often covered by California commercial plans for treatment-resistant depression, typically when there is a documented history of antidepressants that did not work. Plans generally require prior authorization, and we manage that process for you.
Many people maintain their improvement after completing a course of TMS. For others, occasional maintenance sessions or a relapse-prevention plan help protect the gains. We talk through what makes sense based on how you respond.
We offer Spravato (esketamine), an FDA-approved nasal-spray form of ketamine for treatment-resistant depression, given under monitoring in our clinic. We do not provide IV, intramuscular, or compounded oral ketamine. If you are researching ketamine for depression, Spravato is the ketamine-class treatment available here.
Spravato is esketamine, the S-enantiomer of ketamine. It is FDA-approved specifically for treatment-resistant depression and is given as a nasal spray in a certified setting. This differs from racemic IV ketamine, which is used off-label for depression.
You self-administer the nasal spray in our office under supervision, then stay for monitoring. Because of how Spravato can affect you, you are observed for at least two hours after each dose, so plan for roughly two to two and a half hours per visit.
No. You cannot drive for the rest of the day after each Spravato session, so you will need to arrange a ride home.
The induction phase is typically twice a week for about four weeks. After that, sessions are spaced out into an individualized maintenance schedule based on your response.
Spravato is often covered for treatment-resistant depression with prior authorization. We help manage the prior-authorization process and verify your benefits before treatment begins.
Treatment-resistant depression generally means depression that has not improved after at least two different antidepressants taken at an adequate dose for an adequate length of time (often 6 to 8 weeks each). Only a clinician can determine this, so the best next step is an evaluation rather than self-diagnosis.
There is no one-size-fits-all answer. The right choice depends on your treatment history, lifestyle, side-effect tolerance, insurance coverage, and clinical judgment. In some cases the two can be sequenced or combined under clinical supervision. We help you weigh the options during a consultation.
A returning symptom is a signal, not a setback to face alone. Reaching out early, when sleep, energy, or mood first start to slip, gives us the most options, from adjusting your plan to considering maintenance treatment. Contact us promptly if you notice warning signs.
Yes. We treat anxiety with evidence-based options, including medication such as SSRIs, SNRIs, or buspirone and structured therapy approaches. TMS is not FDA-cleared for generalized anxiety, though it is sometimes considered off-label; we discuss what fits your situation.
Yes. OCD care combines psychiatric medication management, referral to evidence-based ERP (exposure and response prevention) therapy, and — for OCD that hasn't responded to those — focal TMS on our Magstim Horizon 3.0 (FDA-cleared as an adjunct for OCD; this is not BrainsWay's Deep TMS). We determine the right approach based on your symptoms and history.
Yes. We provide comprehensive adult ADHD evaluations using a clinical interview, validated rating scales, and history, in our Hayward office or by California telehealth, along with treatment and medication management when appropriate.
We work with a range of insurance providers, and interventional treatments like TMS and Spravato are often covered for treatment-resistant depression with prior authorization. Coverage varies by plan, so we verify your benefits before your appointment.
We offer flexible self-pay options and will discuss costs upfront so you can make an informed decision about your care.
You can book directly through our contact page or call (415) 636-9700 (Mon-Fri 8a-8p, Sat 9a-5p). We help you choose the right first appointment and verify any insurance benefits before you come in.
Business hours
Prefer telehealth? Appointments are scheduled statewide across California — book here.
Book a consultation and let's find the right path forward — together.
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