Individual provider Active NPI

Lynda Nkechi Aduba, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1407393903
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95005833 Issued in CA
Practice address
200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone
(888) 562-5442
Fax
(562) 499-6171
NPI assigned
Jan 23, 2017
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005833 CA
Family Nurse Practitioner 363LF0000X 712998 CA
Nurse Practitioner 363L00000X 95005833 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61270915 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209025150 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95005833 CA Primary

Addresses

Primary practice location

200 Oceangate Ste 100
Long Beach, CA 90802-4317

Mailing address

200 Oceangate
Suite 100
Long Beach, CA 90802-4317
Phone (562) 499-6191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA, IL, AZ4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20170517001404 CA Practitioner - Nurse Practitioner 6507141801 Reassigns benefits to 2 organizations
I20220428002640 WA Practitioner - Nurse Practitioner 6507141801 Reassigns benefits to 1 organization
I20220805002839 IL Practitioner - Nurse Practitioner 6507141801 Reassigns benefits to 1 organization
I20230421000824 AZ Practitioner - Nurse Practitioner 6507141801 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
712998CAMDFamily Nurse Practitioner
209025150ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Care CurrentSince Oct 4, 2024 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince Apr 18, 2022 Accepting new patients
Molina Healthcare of Washington, Inc Current Accepting new patients
Molina Healthcare of Illinois, Inc. CurrentSince May 20, 2022 Accepting new patients
Joseph M Molina MD Professional Corporation-Southern California Past Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

2001 Butterfield Rd
Ste 750
Downers Grove, IL 60515
Phone (630) 381-1757

1520 Kensington Rd
Ste 212
Oak Brook, IL 60523
Phone (855) 687-7861

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

Interoperability endpoints

  • Direct secure messaging: laduba8794@direct-prd.molinahealthcare.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1407393903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191",
            "fax_number": "562-499-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "888-562-5442",
            "fax_number": "562-499-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADUBA",
        "first_name": "LYNDA",
        "middle_name": "NKECHI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005833",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "712998",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005833",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61270915",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209025150",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95005833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.