Healthcare Provider Details

I. General information

NPI: 1235061615
Provider Name (Legal Business Name): NKIRU CHRISTIANA AMAKU MSN,PHN,RN,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 E DOMINGUEZ ST
CARSON CA
90745-1208
US

IV. Provider business mailing address

214 E DOMINGUEZ ST
CARSON CA
90745-1208
US

V. Phone/Fax

Practice location:
  • Phone: 310-956-7641
  • Fax: 424-536-4035
Mailing address:
  • Phone: 310-956-7641
  • Fax: 424-536-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039655
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: