Provider Demographics
NPI:1073109773
Name:PATIENCE AKHIMIEN REGISTERED NURSE PRACTITIONER
Entity Type:Organization
Organization Name:PATIENCE AKHIMIEN REGISTERED NURSE PRACTITIONER
Other - Org Name:PATIENCE AKHIMIEN REGISTERED NURSE PRACTITIONER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR/NP
Authorized Official - Prefix:DR
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:RONKE
Authorized Official - Last Name:AKHIMIEN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:310-956-0556
Mailing Address - Street 1:6515 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8651
Mailing Address - Country:US
Mailing Address - Phone:310-956-0556
Mailing Address - Fax:
Practice Address - Street 1:6515 RED OAK DR
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-8651
Practice Address - Country:US
Practice Address - Phone:310-956-0556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95002442OtherCA BRN