Henrietha Ugochi Iwobi

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95019958 Issued in CA

Practice address

13300 Hawthorne Blvd
Hawthorne, CA 90250

Phone

(424) 365-3031

NPI assigned

Jul 22, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Divine Holistic Care Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Hawthorne, CA
  • NPI 1225815921
  NPD Authorized official

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1629703608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13532 1/2 CHADRON AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902507822",
            "telephone_number": "424-200-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 HAWTHORNE BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "424-365-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWOBI",
        "first_name": "HENRIETHA",
        "middle_name": "UGOCHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95019958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian Iskander, MD
• Mona Youssef Iskander, MD
• Isocare Convalescent Hospital of Monte Vista Inc.
• Isocare Medical Extenders Services in
• Isocare Medical Extenders Services Inc.
• Angela Iwuala
• Jack Shabanian, D.D.S. Inc.
• Lee Alvin Jackson
• Shawana Jackson
• Jaclyn Cruz Speech Language Therapy, Inc. a Professional Corporation

• Psychiatric/Mental Health Nurse Practitioner in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.