Provider Demographics
NPI:1306571591
Name:NWAOKORO, REMIGUS CHIMEZIE
Entity type:Individual
Prefix:
First Name:REMIGUS
Middle Name:CHIMEZIE
Last Name:NWAOKORO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 IBIS RD
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-3098
Mailing Address - Country:US
Mailing Address - Phone:415-370-8412
Mailing Address - Fax:
Practice Address - Street 1:816 IBIS RD
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-3098
Practice Address - Country:US
Practice Address - Phone:415-370-8412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95065556163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult