Individual provider Active NPI

Faith Amarachukwu Onwuka

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1962976456
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95010821 Issued in CA
Practice address
4618 Fountain Ave
Los Angeles, CA 90029-1830
Phone
(323) 953-7170
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95010821 CA Primary

Addresses

Primary practice location

4618 Fountain Ave
Los Angeles, CA 90029-1830

Mailing address

950 S Grand Ave FL 2
Los Angeles, CA 90015-3999
Phone (323) 669-4346

Other identifiers 1

IdentifierTypeStateIssuer
95010821OtherCACALIFORNIA BOARD OF NURSING

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190703001539 CA Practitioner - Nurse Practitioner 3072847565 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95010821CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 16, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 16, 2022 Accepting new patients
St. Johns Community Health CurrentSince Apr 13, 2021 Accepting new patients
Sunny Hills Medical Center Inc. CurrentSince Jan 1, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
St. Johns Community Health CurrentSince Apr 13, 2021 Accepting new patients
St. Johns Community Health Current Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

140 E Commonwealth Ave
Ste 100
Fullerton, CA 92832
Phone (714) 572-3900

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 7

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1962976456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S GRAND AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153999",
            "telephone_number": "323-669-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4618 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291830",
            "telephone_number": "323-953-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONWUKA",
        "first_name": "FAITH",
        "middle_name": "AMARACHUKWU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2023-09-26",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF NURSING",
            "identifier": "95010821",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.