Comfort Daberechi Obinwanne, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F01251104 Issued in CA

Practice address

16729 Yarrow LN
Fontana, CA 92336-6638

Phone

(909) 754-5890

NPI assigned

Mar 3, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Comfort Daberechi Ezeanochie Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1366249831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16729 YARROW LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923366638",
            "telephone_number": "909-754-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16729 YARROW LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923366638",
            "telephone_number": "909-754-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBINWANNE",
        "first_name": "COMFORT",
        "middle_name": "DABERECHI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "F01251104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COMFORT",
            "last_name": "EZEANOCHIE",
            "middle_name": "DABERECHI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Edgar Ochoa, MD
• Paulette Ochoa, COTA
• Rhonda A Ochoa, NP
• Irene H Odom, M.D.

• Primary Care Nurse Practitioner in Fontana, CA
• Providers in Fontana, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.

Verify at the official NPI Registry.