Healthcare Provider Details

I. General information

NPI: 1811049745
Provider Name (Legal Business Name): FERDINAND UWAECHIE LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 COUNTRY HILLS DR
ANTIOCH CA
94509-7319
US

IV. Provider business mailing address

2335 COUNTRY HILLS DR
ANTIOCH CA
94509-7319
US

V. Phone/Fax

Practice location:
  • Phone: 925-608-8700
  • Fax: 925-608-8715
Mailing address:
  • Phone: 925-608-8726
  • Fax: 925-608-8715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: