Provider Demographics
NPI:1316546930
Name:OGUAGHA, CHIKA U (PMHNP)
Entity Type:Individual
Prefix:
First Name:CHIKA
Middle Name:U
Last Name:OGUAGHA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16240 CARMINE ST
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1481
Mailing Address - Country:US
Mailing Address - Phone:424-221-1114
Mailing Address - Fax:
Practice Address - Street 1:16240 CARMINE ST
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1481
Practice Address - Country:US
Practice Address - Phone:424-221-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015739363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty