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General NPI Number Information
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NPI Number | 1740877125
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Entity Type | Individual
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Provider Name | SAMUEL ONYEWUMBU LICDC,PMC, MCAP.
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Gender | Male
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Dates
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Enumeration Date | 12/31/2020
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 1420 WILLOW PASS RD # 200
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City | CONCORD
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State | CA
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Zip | 94520-5823
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Country | US
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Telephone | 925-646-5480
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Fax |
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Provider Business Mailing Address
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Address Line | 85 CITRUS PARK LN
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-1855
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Country | US
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Telephone | 561-574-7900
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0010554
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2233
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 162708
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | 0802589
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License Number State | FL
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