Collins Chukwuebuka Ikueze, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95032860 Issued in CA

Practice address

446 Alta Rd
San Diego, CA 92158-0001

Phone

(619) 671-4400

NPI assigned

Dec 4, 2024

Sex

Male

Sole proprietor

No

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

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southern Coast Psych Medical Associates PC

  • Community/Behavioral Health Agency
  • Hemet, CA
  • NPI 1467269068
  Medicare reassignment NPD

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1881400893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5165 CALLE SANDWAVES UNIT 10",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921546308",
            "telephone_number": "973-814-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921580001",
            "telephone_number": "619-671-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUEZE",
        "first_name": "COLLINS",
        "middle_name": "CHUKWUEBUKA",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95032860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maiko Ikeda, ED.S.
• Tyson Shigeru Ikeda, M.D.
• Ogechi Ikediobi, MD, PHD
• Ikidney Care Clinic
• Ikidney Dialysis
• Sara Ilanit
• Taufaga Ilaoa-Taupau
• Morgan Ilercil
• Anya M Ilfeld, RN, PHN
• Brian Michael Ilfeld, MD

• Psychiatric/Mental Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, 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 Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.