Provider Demographics
NPI:1164598280
Name:ANAKWENZE, EBERE HENRIETTA (PA)
Entity Type:Individual
Prefix:MRS
First Name:EBERE
Middle Name:HENRIETTA
Last Name:ANAKWENZE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1045 ATLANTIC AVENUE
Mailing Address - Street 2:SUITE 715
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3412
Mailing Address - Country:US
Mailing Address - Phone:562-983-5496
Mailing Address - Fax:562-432-1864
Practice Address - Street 1:555 W COMPTON BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3085
Practice Address - Country:US
Practice Address - Phone:310-223-0684
Practice Address - Fax:310-223-0687
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-12-03
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Provider Licenses
StateLicense IDTaxonomies
CAPA14471363LP0200X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant