Provider Demographics
NPI:1639183098
Name:OGBORO, STELLA C (LVN)
Entity type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:C
Last Name:OGBORO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:STELLA
Other - Middle Name:C
Other - Last Name:NWANGUMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:PO BOX 8412
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91346-8412
Mailing Address - Country:US
Mailing Address - Phone:661-755-1344
Mailing Address - Fax:
Practice Address - Street 1:18015 BENEDA LN APT 208
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-5420
Practice Address - Country:US
Practice Address - Phone:661-755-1344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN183717164X00000X
CAHMDRL103707332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5214470001Medicare NSC