Ifeoma Nwufor, FNP/PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95006219 Issued in CA

Practice address

1204 W Gardena Blvd Ste B
Gardena, CA 90247-5923

Phone

(310) 767-7833

NPI assigned

Jun 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, MN2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Prime Care Health Services Inc

  • Home Health Agency
  • Carson, CA
  • NPI 1346694346

  Corporate Director, W-2 Managing Employee

  CMS ownership

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.

• Dadoyan Behavioral Medical Group Inc

  • Psychiatry Physician
  • Sherman Oaks, CA
  • NPI 1841687878
  Medicare reassignment NPD
• Garden of Friends Foundation

  • Internal Medicine Physician
  • Sun City, CA
  • NPI 1578367835
  Medicare reassignment NPD

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

{
    "created_epoch": "1497139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1801325949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17817 HAZELWOOD CT",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907467481",
            "telephone_number": "424-653-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W GARDENA BLVD STE B",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902475923",
            "telephone_number": "310-767-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWUFOR",
        "first_name": "IFEOMA",
        "credential": "FNP/PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-11",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006219",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95006219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert O Nutting, MD
• Chinedu Nwadike
• Nmesomachi Nwoko
• Uchenna Augustina Nwoko, FNP
• Success Nwokolo
• O.H. Barkhordar D.D.S.,Inc.
• O.R. Barkhordar DDS Inc
• Christina O'Brien
• Michaelah Rose O'Connor
• Shira O'Neal-Abend

• Psychiatric/Mental Health Nurse Practitioner in Gardena, CA
• Providers in Gardena, 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 May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.