Provider Demographics
NPI:1487262879
Name:OKEKE, SALLY C (RN)
Entity type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:C
Last Name:OKEKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15607 LAKEWOOD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-4691
Mailing Address - Country:US
Mailing Address - Phone:323-777-9339
Mailing Address - Fax:
Practice Address - Street 1:15607 LAKEWOOD BLVD STE A
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-4691
Practice Address - Country:US
Practice Address - Phone:323-777-9339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA362961163WH0200X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health