Individual provider Active NPI

Chinedu Nwadike

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1255051371
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2022008468 Issued in CA
Practice address
1225 W 190TH St Ste 280
Gardena, CA 90248-4305
Phone
(310) 515-8113
NPI assigned
Aug 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 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 2022008468 CA Primary

Addresses

Primary practice location

1225 W 190TH St Ste 280
Gardena, CA 90248-4305

Mailing address

1000 W Carson St, Torrance, Ca 90502
Torrance, CA 90502
Phone (562) 375-1118

Other practice location 1

1000 W Carson St, Torrance, CA 90502
Torrance, CA 90502
Phone (424) 306-4633

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
I20230419002365 CA Practitioner - Nurse Practitioner 1254796543 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022008468CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Oct 30, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1255051371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST, TORRANCE, CA 90502",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90502",
            "telephone_number": "562-375-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 280",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484305",
            "telephone_number": "310-515-8113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St, Torrance, CA 90502",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "90502",
            "country_code": "US",
            "telephone_number": "424-306-4633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWADIKE",
        "first_name": "CHINEDU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "2022008468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.