Provider Demographics
NPI:1245350461
Name:OSEI NYARKO, ADOWA SERWA (RN CCM)
Entity type:Individual
Prefix:
First Name:ADOWA SERWA
Middle Name:
Last Name:OSEI NYARKO
Suffix:
Gender:F
Credentials:RN CCM
Other - Prefix:
Other - First Name:GIFTY
Other - Middle Name:
Other - Last Name:LA VAR DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN CCM
Mailing Address - Street 1:24910 AVENUE TIBBITTS
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24910 AVENUE TIBBITTS STE 5
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3426
Practice Address - Country:US
Practice Address - Phone:661-771-6609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA790732163W00000X, 163WC1500X, 163WH0200X, 163WH1000X, 163WP0808X, 163WW0000X, 163WA2000X, 163WW0000X
CA4205479163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care