Provider Demographics
NPI:1114488251
Name:CHINAKA, NWOKEDI DECENCY
Entity Type:Individual
Prefix:PROF
First Name:NWOKEDI
Middle Name:DECENCY
Last Name:CHINAKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 W MARCH LN STE 200
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-8250
Mailing Address - Country:US
Mailing Address - Phone:209-478-9862
Mailing Address - Fax:
Practice Address - Street 1:2423 W MARCH LN STE 200
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-8250
Practice Address - Country:US
Practice Address - Phone:209-478-9862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-30
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA928181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical