Provider Demographics
NPI:1568859668
Name:AKPONYE, JANE ANULIKA
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ANULIKA
Last Name:AKPONYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6459 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3009
Mailing Address - Country:US
Mailing Address - Phone:909-708-6615
Mailing Address - Fax:951-371-6205
Practice Address - Street 1:1761 W HOLT AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-3315
Practice Address - Country:US
Practice Address - Phone:909-713-4077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF73954106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist