Healthcare Provider Details

I. General information

NPI: 1619693942
Provider Name (Legal Business Name): OBIAJULUM OKAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date: 06/04/2025
Reactivation Date: 07/24/2025

III. Provider practice location address

2116 ARLINGTON AVE
LOS ANGELES CA
90018-1353
US

IV. Provider business mailing address

2116 ARLINGTON AVE
LOS ANGELES CA
90018-1353
US

V. Phone/Fax

Practice location:
  • Phone: 323-334-9000
  • Fax: 619-374-7134
Mailing address:
  • Phone: 323-334-9000
  • Fax: 619-374-7134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: