Individual
IJEOMA R MBADUGHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9431 HAVEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-5879
(909) 500-2010
(800) 331-4078
Mailing address
9431 HAVEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-5879
(909) 500-2010
(800) 331-4078
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95027780
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95027780
CA
Other
Enumeration date
10/20/2023
Last updated
03/21/2024
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