Individual provider Active NPI

Ihuoma Nnenna Erondu, MD

  • Student in an Organized Health Care Education/Training Program
  • Palo Alto, CA
National Provider Identifier
1104575489
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
401 Quarry Rd
Palo Alto, CA 94304-1419
Phone
(650) 725-5591
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

401 Quarry Rd
Palo Alto, CA 94304-1419

Mailing address

2310 Sweetwood CT
Fulshear, TX 77423-2970
Phone (732) 618-8073

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260609003695 CA Practitioner - Psychiatry 5597236679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rush Medical College of Rush University, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2310 Sweetwood CT
Fulshear, TX 77423-2970

521 Del Medio Ave
Apt 327
Mountain View, CA 94040-1146

801 Gateway Blvd
South San Francisco, CA 94080-7401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1104575489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 SWEETWOOD CT",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774232970",
            "telephone_number": "732-618-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041419",
            "telephone_number": "650-725-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERONDU",
        "first_name": "IHUOMA",
        "middle_name": "NNENNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.