GRACE EBENUWA (NPI# 1164629697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164629697 |
| Entity Type | Individual |
| Full Name | GRACE EBENUWA |
| Practice Address |
12021 Wilmington Ave Los Angeles CA 90059-3019 |
| Mailing Address |
1731 Stearns Dr Los Angeles CA 90035-4627 |
| Practice Telephone | 3106684506 |
| Practice Fax Number | 3107638909 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
RN401793 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12021 WILMINGTON AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059-3019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750351300 | Gangadarshni Chandramohan | Pediatrics | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2006-01-25 |
| 1639704323 | Martin Luther King Jr Community Medical Group-wilmington Ave | Case Manager/Care Coordinator | 12021 Wilmington Ave, Building 11, Suite 1000, Los Angeles, CA 90059 | 2020-03-03 |
| 1114418928 | Exodus Recovery, Inc. | Community/Behavioral Health | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2018-05-29 |
| 1043759855 | Los Angeles County Department of Mental Health | Clinic/Center | 12021 Wilmington Ave, Los Angeles, CA 90059 | 2017-02-14 |
| 1053855064 | Maria Casarez-romero | Rehabilitation Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-09 |
| 1295279453 | Kelsey Collins | Marriage & Family Therapist | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-07 |
| 1639628035 | Stella Cuomo | Student in an Organized Health Care Education/Training Program | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-09-26 |
| 1821443995 | Patanya Matthews | Counselor | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-04-26 |
| 1043677289 | Kita Stovall | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059 | 2016-01-19 |
| 1417314741 | Noele Le Flore | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659666048 | Maggie Lizardi Weiss | Nurse Practitioner | 4900 W Sunset Blvd # 5b, Los Angeles, CA 90027-5814 | 2011-06-14 |
| 1962796748 | Shamma Maria Singh | Nurse Practitioner | 4004 S Vermont Ave Ste 6, Los Angeles, CA 90037-1976 | 2011-06-08 |
| 1346478146 | Cristy Schier | Nurse Practitioner | 1014 N Vermont Ave, Los Angeles, CA 90029-2620 | 2009-06-30 |
| 1750415493 | Shu Feng Jung | Nurse Practitioner | 1075 N Western Ave, # 110, Los Angeles, CA 90029-2307 | 2007-03-15 |
| 1659414670 | Rashmi Ashwin Shroff | Nurse Practitioner | 4301 S Figueroa St Ste F, Los Angeles, CA 90037-2671 | 2007-02-15 |
| 1811034507 | Emmajean Mccreadie | Nurse Practitioner | 2005 Wilshire Blvd, Los Angeles, Los Angeles, CA 90057-3503 | 2007-01-31 |
| 1215356688 | Stephanie Diane Lacroix | Nurse Practitioner | 808 W 58th St, Los Angeles, CA 90037-3632 | 2014-04-14 |
| 1073765913 | Rossana Rosales | Nurse Practitioner | 1240 N Mission Rd, Los Angeles, CA 90033-1019 | 2008-10-22 |
| 1861686487 | Rose Osuna | Nurse Practitioner | 1640 Marengo St, Hra Building 3rd Floor, Los Angeles, CA 90033-1036 | 2007-08-28 |
| 1588862577 | Carrol King-boyd | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2007-07-11 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90059 |
Please comment or provide details below to improve the information on GRACE EBENUWA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.