Provider Demographics
NPI:1962976456
Name:ONWUKA, FAITH AMARACHUKWU
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:AMARACHUKWU
Last Name:ONWUKA
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 1:950 S GRAND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3999
Mailing Address - Country:US
Mailing Address - Phone:323-669-4346
Mailing Address - Fax:
Practice Address - Street 1:4618 FOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1830
Practice Address - Country:US
Practice Address - Phone:323-953-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010821363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95010821OtherCALIFORNIA BOARD OF NURSING