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General NPI Number Information
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NPI Number | 1467963165
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Entity Type | Individual
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Provider Name | CHINOMSO MPUMECHI-ANDY
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Gender | Female
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 02/09/2025
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Provider Practice Location Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811
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Country | US
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Telephone | 619-324-3398
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Fax |
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Provider Business Mailing Address
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Address Line | 7252 ARCHIBALD AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-9170
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95007777
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License Number State | CA
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