Basic Information
| Provider Information | |||||||||
| NPI: | 1043439813 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ANYAOHA | ||||||||
| FirstName: | AMAKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23425 CRENSHAW BLVD #201 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105620166 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2101 ROSECRANS AVE # 3230 | ||||||||
| Address2: | |||||||||
| City: | EL SEGUNDO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902454749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3236288671 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2007 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YS0200X | N | Behavioral Health & Social Service Providers | Counselor | School | 363LF0000X | 23402 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163WA0400X | RN 606596 | CA | Y | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) |
No ID Information.