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General NPI Number Information
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NPI Number | 1043439813
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Entity Type | Individual
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Provider Name | AMAKA LAURETTA ANYAOHA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 2101 ROSECRANS AVE # 3230
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4749
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Country | US
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Telephone | 323-628-8671
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Fax |
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Provider Business Mailing Address
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Address Line | 23425 CRENSHAW BLVD #201
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City | TORRANCE
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State | CA
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Zip | 90505
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Country | US
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Telephone | 310-562-0166
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | RN 606596
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 23402
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23402
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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