Healthcare Provider Details

I. General information

NPI: 1346753019
Provider Name (Legal Business Name): UKAMAKA ONYIA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 S ELM AVE
FRESNO CA
93706-5435
US

IV. Provider business mailing address

2740 S ELM AVE
FRESNO CA
93706-5435
US

V. Phone/Fax

Practice location:
  • Phone: 559-457-5200
  • Fax: 559-457-5296
Mailing address:
  • Phone: 559-457-5200
  • Fax: 559-457-5296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95006091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: