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1669215000
EKENEDILICHUKWU EZENWAKA
STOCKTON, CA
NPI
1669215000
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA 95030565)
Enumeration Date
2024-06-14
Last Update Date
2024-06-14
Business Address
EKENEDILICHUKWU EZENWAKA NP
7707 AUSTIN RD
STOCKTON, CA 95215-8312
Phone number: 209-467-8655
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Mailing Address
EKENEDILICHUKWU EZENWAKA NP
6713 SAO TIAGO WAY
ELK GROVE, CA 95757-3435
Phone number: 323-973-6970
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