Active NPI
Rose Chinasa Acholonu
- Religious Nonmedical Nursing Personnel
- Antioch, CA
National Provider Identifier
1760366272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Religious Nonmedical Nursing Personnel
- License
- 079201340
- Practice address
- 1403 Prewett Ranch Dr
Antioch, CA 94531-8061 - Phone
- (510) 435-8093
- Fax
- (925) 706-2149
- NPI assigned
- Aug 5, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Religious Nonmedical Nursing Personnel | 374T00000X | 079201340 | CA | Primary |
Addresses
Primary practice location
1403 Prewett Ranch Dr
Antioch, CA 94531-8061
Mailing address
1403 Prewett Ranch Dr
Antioch, CA 94531-8061
Phone (510) 435-8093
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
| License | State | Type | Specialty |
|---|---|---|---|
| 079201340 | CA | MD | Religious Nonmedical Nursing Personnel |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1760366272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1403 PREWETT RANCH DR",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318061",
"telephone_number": "510-435-8093",
"fax_number": "925-706-2149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1403 PREWETT RANCH DR",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318061",
"telephone_number": "510-435-8093",
"fax_number": "925-706-2149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACHOLONU",
"first_name": "ROSE",
"middle_name": "CHINASA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-05",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "374T00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Nursing Personnel",
"state": "CA",
"license": "079201340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.