Individual provider Active NPI

Lilian Onyinye Okereke

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1902169196
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10045031 Issued in OR
Practice address
1225 W 190TH St Ste 280
Gardena, CA 90248-4305
Phone
(877) 515-8113
Fax
(877) 538-2102
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95025134 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10045031 OR Primary
Registered Nurse 163W00000X 788779 CA

Addresses

Primary practice location

1225 W 190TH St Ste 280
Gardena, CA 90248-4305

Mailing address

427 C St
212
San Diego, CA 92101-5100
Phone (619) 238-4180

Other practice location 1

427 C St
212
San Diego, CA 92101-5100
Phone (619) 238-4180

Other practice location 2

1225 W 190th St Ste 280
Gardena, CA 90248-4305
Phone (877) 515-8113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 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

Enrollment IDStateProvider typePAC IDDetails
I20230816001833 CA Practitioner - Nurse Practitioner 0042672479 Reassigns benefits to 2 organizations
I20260212003518 OR Practitioner - Nurse Practitioner 0042672479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

770 1St Ave
Suite 250
San Diego, CA 92101-6170
Phone (877) 515-8113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
788779CAMDRegistered Nurse
10045031ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Jan 1, 2026 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Aug 2, 2023 Accepting new patients
Sam-U-L, LLC Psychiatric/Mental Health CurrentSince Feb 1, 2026 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

770 1st Ave
Ste 250
San Diego, CA 92101
Phone (619) 292-8304

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

12725 SW Millikan Way
Ste 300
Beaverton, OR 97005
Phone (503) 303-0304

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1902169196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 C ST",
            "address_2": "212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015100",
            "telephone_number": "619-238-4180",
            "fax_number": "619-238-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 280",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484305",
            "telephone_number": "877-515-8113",
            "fax_number": "877-538-2102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "427 C St",
            "address_2": "212",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921015100",
            "country_code": "US",
            "telephone_number": "619-238-4180",
            "fax_number": "619-238-4245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 W 190th St Ste 280",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484305",
            "country_code": "US",
            "telephone_number": "877-515-8113",
            "fax_number": "877-538-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKEREKE",
        "first_name": "LILIAN",
        "middle_name": "ONYINYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025134",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10045031",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "788779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.