Provider Demographics
NPI:1467840850
Name:CHUKS-ORJI, NANCY (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CHUKS-ORJI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3687 MT DIABLO BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4053 LONE TREE WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-6210
Practice Address - Country:US
Practice Address - Phone:925-756-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2018090222363LP0808X
CA845140363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health