Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 560027 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 560027 | CA |
NPI | 1003067141 |
---|---|
Provider Name | Alice Chinyere Echeta |
First Address | Fontana, CA 92337-6844 |
Second Address | Riverside, CA 92504-2738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2008 |
Last Update Date | 16/11/2018 |