Provider Demographics
NPI:1326648924
Name:IHEAKA, NNENNA CAROLINE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:NNENNA
Middle Name:CAROLINE
Last Name:IHEAKA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:NNENNA
Other - Middle Name:CAROLINE
Other - Last Name:NWOBI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12215 TELEGRAPH RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3344
Mailing Address - Country:US
Mailing Address - Phone:925-282-1778
Mailing Address - Fax:
Practice Address - Street 1:12215 TELEGRAPH RD STE 107
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3344
Practice Address - Country:US
Practice Address - Phone:925-282-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-01
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016524363LP0808X
CA95072101163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult