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General NPI Number Information
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NPI Number | 1720719008
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Entity Type | Individual
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Provider Name | NWAMAKA GLORIA OFFOR
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Gender | Female
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Dates
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Enumeration Date | 06/18/2022
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Last Update Date | 06/18/2022
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Provider Practice Location Address
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Address Line | 2742 W ORANGETHORPE AVE
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City | FULLERTON
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State | CA
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Zip | 92833-4268
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Country | US
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Telephone | 310-433-5012
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Fax |
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Provider Business Mailing Address
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Address Line | 2742 W ORANGETHORPE AVE
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City | FULLERTON
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State | CA
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Zip | 92833-4268
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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 | 364SP0813X
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Taxonomy Name | Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 95020733
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License Number State | CA
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