Individual
EMMANUEL IFEMAZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1225 W 190TH ST STE 280, GARDENA, CA 90248-4305
(877) 515-8113
Mailing address
1225 W 190TH ST STE 280, GARDENA, CA 90248-4305
(877) 515-8113
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95025107
CA
Other
Enumeration date
05/16/2023
Last updated
01/31/2024
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