Individual provider Active NPI

Henrietta Chinwendu Nwaibe, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1508306176
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95003901 Issued in CA
Practice address
1670 E 120TH St
Los Angeles, CA 90059-3026
Phone
(562) 867-7999
NPI assigned
Mar 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95003901 CA Primary

Addresses

Primary practice location

1670 E 120TH St
Los Angeles, CA 90059-3026

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (562) 867-7999

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
I20210715001157 CA Practitioner - Nurse Practitioner 5991107708 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95003901CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baart Community Healthcare CurrentSince Jun 28, 2021 Accepting new patients
Baart Community Healthcare Current Accepting new patients
Baart Community Healthcare CurrentSince Jun 28, 2021 Accepting new patients

Locations

1926 Beverly Blvd
Los Angeles, CA 90057
Phone (213) 353-1140

1701 Zonal Ave
Los Angeles, CA 90033
Phone (323) 223-6146

1720 Lakepointe Dr
Ste 117
Lewisville, TX 75057

Interoperability endpoints

  • Direct secure messaging: henrietta.nwaibefnp.p1@direct.jwch.nextgenshare.com

Organizations & group practices 4

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": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1508306176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "562-867-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593026",
            "telephone_number": "562-867-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAIBE",
        "first_name": "HENRIETTA",
        "middle_name": "CHINWENDU",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95003901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.