Provider Demographics
NPI:1952559114
Name:OLUMBA, APPOLONIA
Entity Type:Individual
Prefix:MRS
First Name:APPOLONIA
Middle Name:
Last Name:OLUMBA
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 1:17034 BELLFLOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5950
Mailing Address - Country:US
Mailing Address - Phone:562-991-1568
Mailing Address - Fax:562-991-1581
Practice Address - Street 1:17034 BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5950
Practice Address - Country:US
Practice Address - Phone:562-991-1568
Practice Address - Fax:562-991-1581
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18339363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily