Provider Demographics
NPI:1376937276
Name:IKHELOWA, YENEOCHIA (MPH, MBA, CPCO)
Entity Type:Individual
Prefix:
First Name:YENEOCHIA
Middle Name:
Last Name:IKHELOWA
Suffix:
Gender:F
Credentials:MPH, MBA, CPCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10759 MAGNOLIA AVE
Mailing Address - Street 2:STE J
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3082
Mailing Address - Country:US
Mailing Address - Phone:951-376-8018
Mailing Address - Fax:951-266-5771
Practice Address - Street 1:10759 MAGNOLIA AVE
Practice Address - Street 2:STE J
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3082
Practice Address - Country:US
Practice Address - Phone:951-376-8018
Practice Address - Fax:951-266-5771
Is Sole Proprietor?:No
Enumeration Date:2015-03-28
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion