Provider Demographics
NPI:1194611285
Name:PRAISE CLINIC A NURSING PC
Entity type:Organization
Organization Name:PRAISE CLINIC A NURSING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UGOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-346-6847
Mailing Address - Street 1:30203 VIA RIVERA
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-4457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24022 VISTA MONTANA STE B
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6479
Practice Address - Country:US
Practice Address - Phone:310-346-6847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty