Individual provider Active NPI

Victoria Ojiako-Ita, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Pablo, CA
National Provider Identifier
1508403551
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95011314 Issued in CA
Practice address
13585 San Pablo Ave
San Pablo, CA 94806-1307
Phone
(510) 417-9552
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95011314 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95011314 CA Primary

Addresses

Primary practice location

13585 San Pablo Ave
San Pablo, CA 94806-1307

Mailing address

13585 San Pablo Ave
San Pablo, CA 94806-1307
Phone (510) 417-9552

Other practice location 1

2235 Challenger Way
Santa Rosa, CA 95407-5458
Phone (707) 565-5014 ext. 5014

Other practice location 2

2521 Seminary Ave
Oakland, CA 94605-1307
Phone (510) 417-9552 ext. 51041

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
I20200507002148 CA Practitioner - Nurse Practitioner 3971934910 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians

Practice addresses (Care Compare)

13585 San Pablo Ave
FL 2
San Pablo, CA 94806-3804
Phone (510) 942-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95011314CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sonoma CurrentSince Mar 1, 2020 Accepting new patients
Contra Costa County CurrentSince Jun 15, 2022 Accepting new patients
Vicita Wellness Nursing PC Psychiatric/Mental Health CurrentSince Oct 7, 2024 Accepting new patients
County of Sonoma Current Accepting new patients
County of Sonoma CurrentSince Mar 1, 2020 Accepting new patients
Contra Costa County CurrentSince Jun 15, 2022 Accepting new patients
Contra Costa County Current Accepting new patients
Contra Costa County Past Accepting new patients

Locations

2001 Salvio St
Ste 28
Concord, CA 94520
Phone (209) 290-8564

1800 Sutter St
Ste 500
Concord, CA 94520
Phone (707) 469-3402

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

13585 San Pablo Ave
Fl 2
San Pablo, CA 94806
Phone (510) 942-4700

2225 Challenger Way
Santa Rosa, CA 95407
Phone (707) 565-4101

1450 Neotomas Ave
Ste 200
Santa Rosa, CA 95405
Phone (707) 565-4131

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1508403551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13585 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948061307",
            "telephone_number": "510-417-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13585 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948061307",
            "telephone_number": "510-417-9552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2235 Challenger Way",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954075458",
            "country_code": "US",
            "telephone_number": "707-565-5014 x5014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2521 Seminary Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946051307",
            "country_code": "US",
            "telephone_number": "510-417-9552 x51041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJIAKO-ITA",
        "first_name": "VICTORIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95011314",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95011314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.