Provider Demographics
NPI:1598382921
Name:ILOKA, AGATHA NDUDI (RN)
Entity Type:Individual
Prefix:MRS
First Name:AGATHA
Middle Name:NDUDI
Last Name:ILOKA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13997 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8824
Mailing Address - Country:US
Mailing Address - Phone:626-384-0404
Mailing Address - Fax:
Practice Address - Street 1:13997 HOLLYWOOD AVE
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-8824
Practice Address - Country:US
Practice Address - Phone:626-384-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA707827163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA707827OtherACADEMIC WORK