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General NPI Number Information
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NPI Number | 1265076715
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Entity Type | Individual
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Provider Name | PAULINE NNE UBANI
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Gender | Female
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 17215 STUDEBAKER RD STE 110
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City | CERRITOS
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State | CA
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Zip | 90703-2521
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Country | US
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Telephone | 562-860-2210
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Fax | 562-860-1154
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Provider Business Mailing Address
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Address Line | 17215 STUDEBAKER RD STE 110
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City | CERRITOS
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State | CA
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Zip | 90703-2521
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Country | US
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Telephone | 562-860-2210
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSB94024356
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License Number State | CA
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