Active NPI
Joy Egungwu
- Psychiatric/Mental Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1194300459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95016916
- Practice address
- 2051 Marengo St
Los Angeles, CA 90033-1352 - Phone
- (310) 409-7085
- NPI assigned
- Mar 17, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95016916 | CA | Primary |
Addresses
Primary practice location
2051 Marengo St
Los Angeles, CA 90033-1352
Mailing address
1225 W 190TH St Ste 280
Gardena, CA 90248-4305
Phone (310) 515-8113
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95016916 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H Soliman Medical Corporation | Psychiatric/Mental Health | Past | Accepting new patients |
Interoperability endpoints
- advancedpsychiatryassociates.joyegungwu@157293.advancedmd-direct.com
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Folsom, CA
- NPI 1700199080
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Folsom, CA
- NPI 1710595889
Psychiatric/Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685318400000",
"number": "1194300459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 W 190TH ST STE 280",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484305",
"telephone_number": "310-515-8113",
"fax_number": "310-538-2102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352",
"telephone_number": "310-409-7085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGUNGWU",
"first_name": "JOY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-17",
"last_updated": "2023-05-29",
"certification_date": "2023-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95016916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 May 29, 2023; 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.