Charles Ekpeyong Udoma, REGISTERED COUNSELOR

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

460 E Carson Plaza Dr Ste 106
Carson, CA 90746-3270

Phone

(310) 532-6030

NPI assigned

Feb 22, 2012

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1982977864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 E CARSON PLAZA DR STE 106",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463270",
            "telephone_number": "310-532-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 E CARSON PLAZA DR STE 106",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463270",
            "telephone_number": "310-532-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDOMA",
        "first_name": "CHARLES",
        "middle_name": "EKPEYONG",
        "name_prefix": "Mr.",
        "credential": "REGISTERED COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Carson, CA
• Providers in Carson, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.