Healthcare Provider Details

I. General information

NPI: 1962939074
Provider Name (Legal Business Name): MARTINA NJOKU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 WILSHIRE BLVD FL 19
LOS ANGELES CA
90048-4920
US

IV. Provider business mailing address

1720 E 120TH ST
LOS ANGELES CA
90059-3052
US

V. Phone/Fax

Practice location:
  • Phone: 800-270-9256
  • Fax: 805-855-4771
Mailing address:
  • Phone: 800-270-9256
  • Fax: 805-855-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: