Provider Demographics
NPI:1578353470
Name:OKPOHO, ENOH DENISE
Entity type:Individual
Prefix:MS
First Name:ENOH
Middle Name:DENISE
Last Name:OKPOHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 BLOSSOM WAY
Mailing Address - Street 2:
Mailing Address - City:CHERRYLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94541-1948
Mailing Address - Country:US
Mailing Address - Phone:510-582-7676
Mailing Address - Fax:
Practice Address - Street 1:494 BLOSSOM WAY
Practice Address - Street 2:
Practice Address - City:CHERRYLAND
Practice Address - State:CA
Practice Address - Zip Code:94541-1948
Practice Address - Country:US
Practice Address - Phone:510-582-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98869104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker