Active NPI
Nneka Patricia Njoku
- Psychiatric/Mental Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1013480813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95010561
- Practice address
- 4211 Avalon Blvd
Los Angeles, CA 90011-5622 - Phone
- (323) 233-0425
- NPI assigned
- Jan 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95010561 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95010561 | CA | Primary |
Addresses
Primary practice location
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Mailing address
12816 Inglewood Ave # 370
Hawthorne, CA 90250-5118
Phone (424) 999-5133
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.kedren.org/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200901001558 | CA | Practitioner - Nurse Practitioner | 2769809029 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95010561 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1013480813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12816 INGLEWOOD AVE # 370",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902505118",
"telephone_number": "424-999-5133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4211 AVALON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115622",
"telephone_number": "323-233-0425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NJOKU",
"first_name": "NNEKA",
"middle_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-04",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95010561",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95010561",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://www.kedren.org/",
"affiliation": "N",
"address_1": "4211 Avalon Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900115622",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.