Individual
HENRIETHA UGOCHI IWOBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13300 HAWTHORNE BLVD, HAWTHORNE, CA 90250
(424) 365-3031
Mailing address
13532 1/2 CHADRON AVE, HAWTHORNE, CA 90250-7822
(424) 200-9015
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95019958
CA
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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