Provider Demographics
NPI:1932098530
Name:NNODIM, CHUKWUDI C
Entity type:Individual
Prefix:
First Name:CHUKWUDI
Middle Name:C
Last Name:NNODIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1804
Mailing Address - Country:US
Mailing Address - Phone:510-691-6164
Mailing Address - Fax:510-691-6164
Practice Address - Street 1:2000 POWELL ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1804
Practice Address - Country:US
Practice Address - Phone:510-691-6164
Practice Address - Fax:510-691-6164
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst