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General NPI Number Information
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NPI Number | 1780534651
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Entity Type | Individual
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Provider Name | NWAKAEGO BEATRICE OKONKWO
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Gender | Female
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 7707 AUSTIN RD
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City | STOCKTON
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State | CA
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Zip | 95215-8312
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Country | US
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Telephone | 209-467-7149
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Fax |
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Provider Business Mailing Address
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Address Line | 315 S PILGRIM ST
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City | STOCKTON
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State | CA
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Zip | 95205-6108
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Country | US
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Telephone | 908-370-8299
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Fax | 908-370-8299
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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 | 95038241
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License Number State | CA
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