Provider Demographics
NPI:1285411637
Name:OKOROAFOR, NKECHINYERE STELLA
Entity type:Individual
Prefix:
First Name:NKECHINYERE
Middle Name:STELLA
Last Name:OKOROAFOR
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:TELECARE CORPORATION
Mailing Address - Street 2:VILLA FAIRMONT MHRC 15200 FOOTHILL BLVD
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578
Mailing Address - Country:US
Mailing Address - Phone:510-352-9690
Mailing Address - Fax:
Practice Address - Street 1:TELECARE CORPORATION
Practice Address - Street 2:VILLA FAIRMONT MHRC 15200 FOOTHILL BLVD
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578
Practice Address - Country:US
Practice Address - Phone:510-352-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95308882163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health