Provider Demographics
NPI:1710029061
Name:IWU, LORETTA OGECHI
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:OGECHI
Last Name:IWU
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LORETTA
Other - Middle Name:OGECHI
Other - Last Name:NJOKU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 THE ALAMEDA
Mailing Address - Street 2:ALLIANCE FOR COMMUNITY CARE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1136
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:408-254-9960
Practice Address - Street 1:1935 KIDDER AVENUE
Practice Address - Street 2:A S S I S T SOLANO OUTPATIENT SERVICES
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3919
Practice Address - Country:US
Practice Address - Phone:707-425-2741
Practice Address - Fax:707-425-2862
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator