Healthcare Provider Details

I. General information

NPI: 1417840299
Provider Name (Legal Business Name): NGOZI OGANA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2025
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 BROADSTONE PKWY APT 3317
FOLSOM CA
95630-6877
US

IV. Provider business mailing address

1550 BROADSTONE PKWY APT 3317
FOLSOM CA
95630-6877
US

V. Phone/Fax

Practice location:
  • Phone: 279-842-8462
  • Fax:
Mailing address:
  • Phone: 279-842-8462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number01326845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: