Active NPI
Maureen Nnenna Okereke
- Psychiatric/Mental Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1205393998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95011011
- Practice address
- 4211 Avalon Blvd
Los Angeles, CA 90011-5622 - Phone
- (323) 233-0425
- NPI assigned
- Feb 28, 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95011011 | CA | Primary |
| Family Nurse Practitioner | 363LF0000X | 95011011 | CA |
Addresses
Primary practice location
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Mailing address
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 582-2251
Other practice location 1
2115 N Wilmington Ave
Compton, CA 90222-2030
Phone (323) 541-1411
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 |
|---|---|---|---|
| 95011011 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Johns Community Health | Current | Accepting new patients | |
| St. Johns Community Health | Current | Accepting new patients | |
| St. Johns Community Health | Current | Accepting new patients | |
| St. Johns Community Health | Past | Accepting new patients |
Locations
2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- maureen.okereke@sjch.eclinicaldirectplus.com
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1073653630
-
- Community Health Clinic/Center
- Compton, CA
- NPI 1043542111
-
- Community Health Clinic/Center
- Los Angeles, CA
- NPI 1073363768
-
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1780376947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774569600000",
"number": "1205393998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 AVALON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115622",
"telephone_number": "323-582-2251",
"fax_number": "323-582-2251"
},
{
"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": [
{
"address_1": "2115 N Wilmington Ave",
"address_purpose": "LOCATION",
"city": "Compton",
"state": "CA",
"postal_code": "902222030",
"country_code": "US",
"telephone_number": "323-541-1411",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OKEREKE",
"first_name": "MAUREEN",
"middle_name": "NNENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-28",
"last_updated": "2026-03-27",
"certification_date": "2026-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95011011",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95011011",
"primary": false
}
],
"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 Mar 27, 2026; 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.