Individual provider Active NPI

Chinwe Julian Anekwe

  • Psychiatric/Mental Health Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1063148419
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95018973 Issued in CA
Practice address
11007 Skyglow Dr
Rancho Cucamonga, CA 91730-9205
Phone
(310) 908-2120
NPI assigned
Jul 28, 2022
Last updated
Feb 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1063148419 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95018973 CA Primary

Addresses

Primary practice location

11007 Skyglow Dr
Rancho Cucamonga, CA 91730-9205

Mailing address

11007 Skyglow Dr
Rancho Cucamonga, CA 91730-9205
Phone (310) 908-2120

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222002804 CA Practitioner - Nurse Practitioner 3375913908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone (909) 335-3026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1063148419CAMDPsychiatric/Mental Health Nurse Practitioner
95018973CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health CurrentSince Nov 30, 2022 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health Current Accepting new patients
Inland Psychiatric Medical Group, Inc CurrentSince Nov 30, 2022 Accepting new patients
Inland Psychiatric Medical Group Inc Psychiatric/Mental Health PastSince Jul 31, 2023 Accepting new patients

Locations

540 W Baseline Rd
Ste 3
Claremont, CA 91711
Phone (909) 542-0633

12442 Limonite Ave
Unit 104
Eastvale, CA 91752
Phone (951) 344-4451

162 N Santa Fe St
Hemet, CA 92543
Phone (951) 506-9522

24432 Muirlands Blvd
Ste 131
Lake Forest, CA 92630
Phone (714) 520-3000

23110 Atlantic Cir
Ste F
Moreno Valley, CA 92553
Phone (951) 243-6455

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

17310 Bear Valley Rd
Ste B101
Victorville, CA 92395
Phone (760) 660-6798

36320 Inland Valley Dr
Ste 303
Wildomar, CA 92595
Phone (951) 373-6803

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1063148419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11007 SKYGLOW DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309205",
            "telephone_number": "310-908-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11007 SKYGLOW DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309205",
            "telephone_number": "310-908-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANEKWE",
        "first_name": "CHINWE",
        "middle_name": "JULIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "1063148419",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95018973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.