Provider Demographics
NPI:1942739263
Name:UDEH-OKEY, ANTHONIA (FNP)
Entity Type:Individual
Prefix:MS
First Name:ANTHONIA
Middle Name:
Last Name:UDEH-OKEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:ANTHONIA
Other - Middle Name:OBIAGELI
Other - Last Name:UDEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11910 OLIVE GLEN LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-5358
Mailing Address - Country:US
Mailing Address - Phone:310-956-0549
Mailing Address - Fax:
Practice Address - Street 1:711 N ALVARADO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-4016
Practice Address - Country:US
Practice Address - Phone:213-381-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA646425363LF0000X
CA2021000785363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily