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General NPI Number Information
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NPI Number | 1053908194
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Entity Type | Individual
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Provider Name | MRS. OKWUDIRI ECHEGI
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Gender | Female
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Dates
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Enumeration Date | 12/23/2020
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 1444 CARLY CREEK DR
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City | PATTERSON
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State | CA
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Zip | 95363-8764
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Country | US
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Telephone | 209-605-6817
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Fax |
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Provider Business Mailing Address
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Address Line | 1444 CARLY CREEK DR
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City | PATTERSON
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State | CA
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Zip | 95363-8764
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Country | US
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Telephone | 209-605-6817
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA59468
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License Number State | CA
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