Healthcare Provider Details
I. General information
NPI: 1982515292
Provider Name (Legal Business Name): UJ INNER PEACE HEALTHCARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
309 PINE AVE
LONG BEACH CA
90802-2327
US
IV. Provider business mailing address
1455 W REDONDO BEACH BLVD UNIT 3668
GARDENA CA
90247-6592
US
V. Phone/Fax
- Phone: 805-876-4522
- Fax: 607-228-4842
- Phone: 805-876-4522
- Fax: 607-228-4842
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
UGOCHI
NNADOZIE
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: DNP, FNP-C, PMHNP-BC
Phone: 805-876-4522