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General NPI Number Information
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NPI Number | 1902261613
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Entity Type | Individual
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Provider Name | PROMISE OGBONNA ALOZIE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 07/04/2024
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Provider Practice Location Address
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Address Line | 400 N PEPPER AVE
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City | COLTON
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State | CA
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Zip | 92324
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Country | US
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Telephone | 909-580-3144
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Fax | 909-580-2165
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Provider Business Mailing Address
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Address Line | 26520 CACTUS AVE
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City | MORENO VALLEY
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State | CA
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Zip | 92555-3927
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Country | US
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Telephone | 951-955-4485
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 820364
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95030353
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License Number State | CA
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