Healthcare Provider Details

I. General information

NPI: 1134178676
Provider Name (Legal Business Name): CECILIA U NWOKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BROADWAY STE 1100, PRIMARY CARE CLINIC
SACRAMENTO CA
95820
US

IV. Provider business mailing address

10010 SPRING VIEW WAY
ELK GROVE CA
95757
US

V. Phone/Fax

Practice location:
  • Phone: 916-874-9670
  • Fax: 916-874-9297
Mailing address:
  • Phone: 916-714-5676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN379667
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN379667
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: