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General NPI Number Information
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NPI Number | 1770175291
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Entity Type | Organization
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Legal Business Name | OMANYE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 02/05/2021
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 24950 REDLANDS BLVD STE F
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City | LOMA LINDA
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State | CA
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Zip | 92354-4028
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Country | US
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Telephone | 909-801-0439
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Fax | 909-283-4035
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Provider Business Mailing Address
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Address Line | 24950 REDLANDS BLVD STE F
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City | LOMA LINDA
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State | CA
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Zip | 92354-4028
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Country | US
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Telephone | 909-801-0439
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Fax | 909-283-4035
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Authorized Official
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Title or Position | CEO
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Name | DR. PRISCILLA NAAMOMO OTUBUAH
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Credential | PHD, DNP, PMHNP-BC
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Telephone | 909-801-0439
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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 |
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License Number State |
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