Provider Demographics
NPI:1346094422
Name:ONYE, IFEANYI CHRISTIAN SR (NP)
Entity type:Individual
Prefix:
First Name:IFEANYI
Middle Name:CHRISTIAN
Last Name:ONYE
Suffix:SR
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3763 ARLINGTON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2610
Mailing Address - Country:US
Mailing Address - Phone:310-339-4313
Mailing Address - Fax:
Practice Address - Street 1:3763 ARLINGTON AVE STE 104
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2610
Practice Address - Country:US
Practice Address - Phone:310-339-4313
Practice Address - Fax:310-497-5754
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028507363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health