Individual provider Active NPI

Ifeoma Sylvia Onyeagoro

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1871378133
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95025744 Issued in CA
Practice address
10024 S Vermont Ave
Los Angeles, CA 90044-3112
Phone
(323) 756-1412
NPI assigned
Aug 25, 2023
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95025744 CA Primary
Registered Nurse 163W00000X 783577 CA

Addresses

Primary practice location

10024 S Vermont Ave
Los Angeles, CA 90044-3112

Mailing address

10024 S Vermont Ave
Los Angeles, CA 90044-3112
Phone (323) 756-1412

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
783577CAMDRegistered Nurse
95025744CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1871378133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10024 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443112",
            "telephone_number": "323-756-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10024 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443112",
            "telephone_number": "323-756-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYEAGORO",
        "first_name": "IFEOMA",
        "middle_name": "SYLVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025744",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "783577",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.