Healthcare Provider Details

I. General information

NPI: 1225630767
Provider Name (Legal Business Name): IJEOMA ONYEJIJI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 E SANDPOINT CT
CARSON CA
90746-1527
US

IV. Provider business mailing address

511 N HOLLYWOOD WAY
BURBANK CA
91505-3406
US

V. Phone/Fax

Practice location:
  • Phone: 323-516-5023
  • Fax:
Mailing address:
  • Phone: 818-841-0710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: