Chinomso Mpumechi-Andy

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95007777 Issued in CA

Practice address

1401 21St St
Ste R
Sacramento, CA 95811

Phone

(619) 324-3398

NPI assigned

Oct 20, 2017

Last updated

Feb 9, 2025By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739059200000",
    "number": "1467963165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7252 ARCHIBALD AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917019170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 21ST ST",
            "address_2": "STE R",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95811",
            "telephone_number": "619-324-3398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 N Mountain Ave Ste 128",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917621132",
            "country_code": "US",
            "telephone_number": "909-949-9299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MPUMECHI-ANDY",
        "first_name": "CHINOMSO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2025-02-09",
        "certification_date": "2025-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA -BRN",
            "identifier": "95007777",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.