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NPI Code Detail

MEDICARE: MR. PRINCE OCANSEY FNP

MEDICARE:  MR. PRINCE  OCANSEY  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP21235CA

General Provider Information

NPI Number : 1164708640
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PRINCE OCANSEY FNP
Provider Business Mailing Address
First Line : 9415 MISSION BLVD STE P
Second Line :
City : JURUPA VALLEY
State : CA
Zip : 92509-2600
Country : US
Telephone Number : 833-865-8263
Fax Number : 951-742-8687
Provider Business Practice Location Address
First Line : 1050 KENDALL DR STE F
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92407-4125
Country : US
Telephone Number : 909-352-6655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2011
Last Update Date : 08/22/2023

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Directions to “ MR. PRINCE OCANSEY FNP” Practice Location

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