Provider Demographics
NPI:1841908597
Name:ANUKAM, CHINWENDU CLAUDIA
Entity type:Individual
Prefix:
First Name:CHINWENDU
Middle Name:CLAUDIA
Last Name:ANUKAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:CHINWENDU
Other - Last Name:ANUKAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16522 OASIS MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1110
Mailing Address - Country:US
Mailing Address - Phone:817-714-5692
Mailing Address - Fax:
Practice Address - Street 1:29101 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352-9706
Practice Address - Country:US
Practice Address - Phone:909-336-3651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-11
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1098118363LP0808X
CA95032456363LP0808X
RIAPRN04290363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health