Healthcare Provider Details

I. General information

NPI: 1679288674
Provider Name (Legal Business Name): NANCY OGECHI UMENYILORAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22019 PROPELLO DR
SANTA CLARITA CA
91350-8548
US

IV. Provider business mailing address

22019 PROPELLO DR
SANTA CLARITA CA
91350-8548
US

V. Phone/Fax

Practice location:
  • Phone: 562-884-5019
  • Fax:
Mailing address:
  • Phone: 310-384-7487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95023721
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95034734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: