Provider Demographics
NPI:1013452432
Name:NABAWI, ISOKE
Entity Type:Individual
Prefix:
First Name:ISOKE
Middle Name:
Last Name:NABAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-3513
Mailing Address - Country:US
Mailing Address - Phone:323-249-2950
Mailing Address - Fax:310-609-0301
Practice Address - Street 1:5849 CROCKER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1311
Practice Address - Country:US
Practice Address - Phone:323-234-4445
Practice Address - Fax:323-234-4477
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96556106H00000X
CA12827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist