Healthcare Provider Details

I. General information

NPI: 1124754015
Provider Name (Legal Business Name): SALOME CHIZOBA OGU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24050 SILVA AVE APT 16
HAYWARD CA
94544-1539
US

IV. Provider business mailing address

24050 SILVA AVE APT 16
HAYWARD CA
94544-1539
US

V. Phone/Fax

Practice location:
  • Phone: 510-444-9758
  • Fax:
Mailing address:
  • Phone: 510-444-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: