Healthcare Provider Details

I. General information

NPI: 1588314413
Provider Name (Legal Business Name): CHRISTIANA NNEDIUTO ANYANWU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N ROSE AVE STE 210
OXNARD CA
93030-7639
US

IV. Provider business mailing address

3400 DATA DR ATTENTION: CREDENTIALING AND PAYER ENROLLMENT DEPARTMEN
RANCHO CORDOVA CA
95670
US

V. Phone/Fax

Practice location:
  • Phone: 805-384-8071
  • Fax: 805-983-0803
Mailing address:
  • Phone: 916-851-2462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA25767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: