Provider Demographics
NPI:1144032103
Name:IWUCHUKWU, RITA ADORA (NP)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:ADORA
Last Name:IWUCHUKWU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2459 TAYLOR WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8295
Mailing Address - Country:US
Mailing Address - Phone:925-817-8533
Mailing Address - Fax:
Practice Address - Street 1:5366 THUNDERBIRD CT
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-9052
Practice Address - Country:US
Practice Address - Phone:925-817-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily