Healthcare Provider Details

I. General information

NPI: 1912864000
Provider Name (Legal Business Name): TOPE ONIKEKU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19350 BUSINESS CENTER DR STE 103
NORTHRIDGE CA
91324-6440
US

IV. Provider business mailing address

19350 BUSINESS CENTER DR
NORTHRIDGE CA
91324-3500
US

V. Phone/Fax

Practice location:
  • Phone: 866-625-8115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025024366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: