Healthcare Provider Details

I. General information

NPI: 1477483741
Provider Name (Legal Business Name): MID-CITY BEHAVIORAL HEALTH NURSING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 E CALBAS ST # C
CARSON CA
90745-3314
US

IV. Provider business mailing address

816 E CALBAS ST # C
CARSON CA
90745-3314
US

V. Phone/Fax

Practice location:
  • Phone: 562-340-5289
  • Fax: 714-333-4165
Mailing address:
  • Phone: 562-340-5289
  • Fax: 714-333-4165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHINEDU EMMANUEL NWANKWO
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: NWANKWO
Phone: 562-340-5289