Provider Demographics
NPI:1629695184
Name:MEREMIKWU, CLIFFORD UZOMA
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:UZOMA
Last Name:MEREMIKWU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18509 LABRADOR ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1933
Mailing Address - Country:US
Mailing Address - Phone:818-974-2807
Mailing Address - Fax:
Practice Address - Street 1:3001 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5293
Practice Address - Country:US
Practice Address - Phone:323-299-9554
Practice Address - Fax:323-299-9540
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor