Healthcare Provider Details

I. General information

NPI: 1962271445
Provider Name (Legal Business Name): MR. DAN OGOCHUKU ONU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 40TH ST STE 100
OAKLAND CA
94609-2633
US

IV. Provider business mailing address

1815 WILLIAM BIRD AVE
SACRAMENTO CA
95835-1712
US

V. Phone/Fax

Practice location:
  • Phone: 510-318-6137
  • Fax:
Mailing address:
  • Phone: 916-370-6594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: