Healthcare Provider Details

I. General information

NPI: 1013384494
Provider Name (Legal Business Name): VICTOR OGBEIDE PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16350 FILBERT ST
SYLMAR CA
91342-1002
US

IV. Provider business mailing address

9808 VENICE BLVD STE 505
CULVER CITY CA
90232-6818
US

V. Phone/Fax

Practice location:
  • Phone: 818-364-2011
  • Fax:
Mailing address:
  • Phone: 310-945-3350
  • Fax: 310-945-3356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95040261
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number829448
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: