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NPI Code Detail

MEDICARE: ENYINNA ANYADIEGWU

MEDICARE: ENYINNA ANYADIEGWU
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1457859597
Entity Type Code : Individual
Provider Name (Legal Business Name) : ENYINNA ANYADIEGWU
Provider Business Mailing Address
First Line : 21600 OXNARD ST
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-4976
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 75 PARK CREEK DR STE 104
Second Line :
City : CLOVIS
State : CA
Zip : 93611-4432
Country : US
Telephone Number : 559-460-9090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2018
Last Update Date : 01/23/2018

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Directions to “ ENYINNA ANYADIEGWU ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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