Individual provider Active NPI

Chika U Oguagha, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1316546930
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95015739 Issued in CA
Practice address
16240 Carmine St
Fontana, CA 92336-1481
Phone
(424) 221-1114
NPI assigned
Oct 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 95015739 CA Primary

Addresses

Primary practice location

16240 Carmine St
Fontana, CA 92336-1481

Mailing address

16240 Carmine St
Fontana, CA 92336-1481
Phone (424) 221-1114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220414001950 CA Practitioner - Nurse Practitioner 5193111318 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95015739CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David Desai MD Inc Single Specialty CurrentSince Apr 1, 2022 Accepting new patients
Ezim Ezim LLC Single Specialty CurrentSince Sep 3, 2025 Accepting new patients

Locations

2131 Elks Dr
Ste 104
Sn Bernrdno, CA 92404
Phone (909) 966-5500

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": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1316546930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16240 CARMINE ST",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361481",
            "telephone_number": "424-221-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16240 CARMINE ST",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361481",
            "telephone_number": "424-221-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUAGHA",
        "first_name": "CHIKA",
        "middle_name": "U",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95015739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.