Provider Demographics
NPI:1073060711
Name:NDUBAKU, UGO N (DNP, NP-C, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:UGO
Middle Name:N
Last Name:NDUBAKU
Suffix:
Gender:F
Credentials:DNP, NP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27240 TURNBERRY LN STE 200
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1045
Mailing Address - Country:US
Mailing Address - Phone:661-289-6992
Mailing Address - Fax:
Practice Address - Street 1:27240 TURNBERRY LN STE 200
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1045
Practice Address - Country:US
Practice Address - Phone:661-289-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004701363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner