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MARTHA N ADIGWE-MOZIA NP
Psychiatric/Mental Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1225186133
Individual Registrant: MARTHA N ADIGWE-MOZIA NP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
40 E MINARETS AVE PINEDALE, CA 93650-1239 US
Tel: 559-436-0482 Fax: --
Tel: 559-436-0482 Fax: --
Contact information for business:
14150 GRANT ST SUITE 78 MORENO VALLEY, CA 92553-9114 US
Tel: 310-539-5722 Fax: --
Tel: 310-539-5722 Fax: --
Registration Information:
NPI: 1225186133
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Psychiatric/Mental Health | CA | 11282 |
| N | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | CA | NP11282 |
| N | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | CA | 11282 |
| N | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | CA | G1112004 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| RAILROAD MEDICARE | DU4034-P01508618 | CA | 01 |
| EFF. 6/16/15 | CA | 05 |
