Individual provider Active NPI

Osita Stella Nlemchukwu

  • Psychiatric/Mental Health Nurse Practitioner
  • Stockton, CA
National Provider Identifier
1538987284
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95033321 Issued in CA
Practice address
4719 Quail Lakes Dr Ste G1108
Stockton, CA 95207-8140
Phone
(832) 904-6531
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95033321 CA Primary

Addresses

Primary practice location

4719 Quail Lakes Dr Ste G1108
Stockton, CA 95207-8140

Mailing address

4719 Quail Lakes Dr Ste G1108
Stockton, CA 95207-8140
Phone (832) 904-6531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, CA, OR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20250225002850 CO Practitioner - Nurse Practitioner 9436679131 Reassigns benefits to 1 organization
I20250226002012 CA Practitioner - Nurse Practitioner 9436679131 Reassigns benefits to 2 organizations
I20250731003978 OR Practitioner - Nurse Practitioner 9436679131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1902 Wright PL
FL 2
Carlsbad, CA 92008-6583
Phone (888) 515-3834

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95033321CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Credostar Psychiatric Nursing Corporation Psychiatric/Mental Health CurrentSince Feb 23, 2025 Accepting new patients
Memory Check Psychological Services, a Professional Corporation Psychiatric/Mental Health CurrentSince Apr 8, 2025 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jan 24, 2025 Accepting new patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Jan 24, 2025 Accepting new patients

Locations

1902 Wright Pl
Fl 2
Carlsbad, CA 92008
Phone (929) 468-2465

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

348 Iris Dr
Salinas, CA 93906
Phone (831) 449-5496

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

4719 Quail Lakes Dr
Ste G1108
Stockton, CA 95207
Phone (832) 904-6531

7447 Sepulveda Blvd
Van Nuys, CA 91405
Phone (818) 787-3400

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

10260 SW Greenburg Rd
Fl 4
Tigard, OR 97223
Phone (503) 405-9338

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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1538987284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 QUAIL LAKES DR STE G1108",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078140",
            "telephone_number": "832-904-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 QUAIL LAKES DR STE G1108",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078140",
            "telephone_number": "832-904-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NLEMCHUKWU",
        "first_name": "OSITA",
        "middle_name": "STELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95033321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.