Provider Demographics
NPI:1124754015
Name:OGU, SALOME CHIZOBA
Entity type:Individual
Prefix:
First Name:SALOME
Middle Name:CHIZOBA
Last Name:OGU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24050 SILVA AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-1539
Mailing Address - Country:US
Mailing Address - Phone:510-444-9758
Mailing Address - Fax:
Practice Address - Street 1:24050 SILVA AVE APT 16
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1539
Practice Address - Country:US
Practice Address - Phone:510-444-9758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool