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General NPI Number Information
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NPI Number | 1720884612
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Entity Type | Individual
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Provider Name | THERESIA ANANDA ONYANGO
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Gender | Female
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 510 PLAZA DR STE 170
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City | FOLSOM
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State | CA
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Zip | 95630-4790
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Country | US
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Telephone | 877-272-5818
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Fax |
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Provider Business Mailing Address
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Address Line | 25925 BARTON RD UNIT 134
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City | LOMA LINDA
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State | CA
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Zip | 92354-5606
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Country | US
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Telephone | 909-239-7835
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95032223
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License Number State | CA
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