Healthcare Provider Details

I. General information

NPI: 1770069254
Provider Name (Legal Business Name): CHUKWUMA CHRISTOPHER ENUNWA I REGISTERED COUNSELOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4705 N SONORA AVE STE 113
FRESNO CA
93722-3965
US

IV. Provider business mailing address

5939 N CASPIAN AVE
FRESNO CA
93723-8127
US

V. Phone/Fax

Practice location:
  • Phone: 559-276-7558
  • Fax: 559-276-7568
Mailing address:
  • Phone: 559-779-5394
  • Fax: 559-276-7568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: