Provider Demographics
NPI:1013136092
Name:IFEJOKU, JAPHET OKEY (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:JAPHET
Middle Name:OKEY
Last Name:IFEJOKU
Suffix:
Gender:M
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 818
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2307
Mailing Address - Country:US
Mailing Address - Phone:310-505-0268
Mailing Address - Fax:
Practice Address - Street 1:3540 WILSHIRE BLVD
Practice Address - Street 2:SUITE 818
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2307
Practice Address - Country:US
Practice Address - Phone:213-383-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA085764101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA085764OtherCAADAC
CA190479ANOtherFACILITY ADP NUMBER
CA190479ANOtherFACILITY ADP NUMBER