Healthcare Provider Details

I. General information

NPI: 1598569824
Provider Name (Legal Business Name): ONYEKWERE C ANYANWU REGISTERED NURSING MSN RN PHN PMHNP-BC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 W 160TH ST
GARDENA CA
90247-4409
US

IV. Provider business mailing address

1215 W 160TH ST
GARDENA CA
90247-4409
US

V. Phone/Fax

Practice location:
  • Phone: 903-617-5098
  • Fax:
Mailing address:
  • Phone: 903-617-5098
  • Fax:

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: DR. ONYEKWERE C ANYANWU
Title or Position: OWNER
Credential:
Phone: 903-617-5098