MEDICARE: CHIAMAKA UDECHUKWU

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1437626470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIAMAKA UDECHUKWU

Provider Business Mailing Address
First Line	:	20060 PRAIRIE ST APT 439
Second Line	:
City	:	CHATSWORTH
State	:	CA
Zip	:	91311-6579
Country	:	US
Telephone Number	:	909-753-5761
Fax Number	:

Provider Business Practice Location Address
First Line	:	3816 AIRWAY AVE
Second Line	:	SUITE A
City	:	COSTA MESA
State	:	CA
Zip	:	92626
Country	:	US
Telephone Number	:	714-881-0427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2018
Last Update Date	:	02/09/2026

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