Individual provider Active NPI

Nwamaka Gloria Offor

  • Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
  • Fullerton, CA
National Provider Identifier
1720719008
Registry record updated Jun 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0813X
License
95020733 Issued in CA
Practice address
2742 W Orangethorpe Ave
Fullerton, CA 92833-4268
Phone
(310) 433-5012
NPI assigned
Jun 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist 364SP0813X 95020733 CA Primary

Addresses

Primary practice location

2742 W Orangethorpe Ave
Fullerton, CA 92833-4268

Mailing address

2742 W Orangethorpe Ave
Fullerton, CA 92833-4268

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Amicable2k4@yahoo.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95020733CAMDGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1655510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655510400000",
    "number": "1720719008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 W ORANGETHORPE AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2742 W ORANGETHORPE AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334268",
            "telephone_number": "310-433-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFOR",
        "first_name": "NWAMAKA",
        "middle_name": "GLORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-18",
        "last_updated": "2022-06-18",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0813X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric",
            "state": "CA",
            "license": "95020733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Amicable2k4@yahoo.com",
            "affiliation": "N",
            "address_1": "2742 W Orangethorpe Ave",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928334268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.