Provider Demographics
NPI:1821521063
Name:AMUCHIE, EMMANUEL (PSYCHIATRIC TECH)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:AMUCHIE
Suffix:
Gender:M
Credentials:PSYCHIATRIC TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9853 CEDAR ST APT 9
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6958
Mailing Address - Country:US
Mailing Address - Phone:562-396-7915
Mailing Address - Fax:
Practice Address - Street 1:9853 CEDAR ST APT 9
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6958
Practice Address - Country:US
Practice Address - Phone:562-396-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 34660247200000X
CAPT34660167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other