Individual provider Active NPI

Joy Egungwu

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1194300459
Registry record updated May 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95016916 Issued in CA
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

Updated by the provider on May 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211112000906 CA Practitioner - Nurse Practitioner 4587053566 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95016916CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
H Soliman Medical Corporation Psychiatric/Mental Health PastSince Jun 27, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.