Provider Demographics
NPI:1114793478
Name:HOMMEY, UGOCHI IJEOMA (FNP)
Entity type:Individual
Prefix:
First Name:UGOCHI
Middle Name:IJEOMA
Last Name:HOMMEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 ATLANTIC AVE STE 818
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3410
Mailing Address - Country:US
Mailing Address - Phone:562-436-8117
Mailing Address - Fax:
Practice Address - Street 1:1045 ATLANTIC AVE STE 818
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3410
Practice Address - Country:US
Practice Address - Phone:562-436-8117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026275363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily