MS. EUCHARIA OBIANUJU MADUAFOKWA PMHNP-BC
Complete NPI Record 1487237889
Nurse Practitioner - Psychiatric/Mental Health in Folsom, CA
Active since May 03, 2021PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Ms. Eucharia Obianuju Maduafokwa, PMHNP-BC (NPI 1487237889), an individual nurse practitioner provider in Folsom, CA. All 42 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1487237889 Field 1/42
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/42
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: MADUAFOKWA Field 3/42
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: EUCHARIA Field 4/42
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: OBIANUJU Field 5/42
- The middle name of the provider, if the provider is an individual.
- Provider Name Prefix Text: MS. Field 6/42
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Credential Text: PMHNP-BC Field 7/42
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 510 PLAZA DR STE 170 Field 8/42
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: FOLSOM Field 9/42
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: CA Field 10/42
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 956304790 Field 11/42
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 12/42
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 9163519400 Field 13/42
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 9163519449 Field 14/42
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 510 PLAZA DR STE 170 Field 15/42
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: FOLSOM Field 16/42
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: CA Field 17/42
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 956304790 Field 18/42
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 19/42
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 9163519400 Field 20/42
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 9163519449 Field 21/42
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 24/42
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363LP0808X Field 25/42
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 95017052 Field 26/42
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: CA Field 27/42
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 28/42
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 1032480 Field 29/42
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 30/42
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: TX Field 31/42
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: APRN-CNP Field 32/42
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 2: 95062461 Field 33/42
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 01 Field 34/42
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: CA Field 35/42
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 2: REGISTETRED NURSE Field 36/42
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 3: 95017052 Field 37/42
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 3: 01 Field 38/42
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 3: CA Field 39/42
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 3: NURSE PRACTITIONER Field 40/42
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Sole Proprietor: N Field 41/42
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 33
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1501 W Cameron Ave Ste 300-129
Location 1/33West Covina, CA 91790-2724 · Phone (916) 351-9400 · Fax (916) 351-9449
1101 Maidu Dr
Location 2/33Auburn, CA 95603-5864 · Phone (916) 351-9400 · Fax (916) 351-9449
15720 Ventura Blvd Ste 210
Location 3/33Encino, CA 91436-2954 · Phone (916) 351-9400 · Fax (916) 351-9449
1040 Park Ave Ste 200-A
Location 4/33San Jose, CA 95126-3075 · Phone (916) 351-9400 · Fax (916) 351-9449
2008 W Dorothea Ave Ste 203
Location 5/33Visalia, CA 93277-7300 · Phone (916) 351-9400 · Fax (916) 351-9449
169 Hartnell Ave Ste 110
Location 6/33Redding, CA 96002-1849 · Phone (916) 351-9400 · Fax (916) 351-9449
3200 4th Ave Ste 200G
Location 7/33San Diego, CA 92103-5716 · Phone (916) 351-9400 · Fax (916) 351-9449
1254 Mission St Ste 220
Location 8/33San Francisco, CA 94103-2706 · Phone (916) 351-9400 · Fax (916) 351-9449
3711 Long Beach Blvd Ste 4045
Location 9/33Long Beach, CA 90807-3320 · Phone (916) 351-9400 · Fax (916) 351-9449
30 E San Joaquin St Ste 203B
Location 10/33Salinas, CA 93901-2947 · Phone (916) 351-9400 · Fax (916) 351-9449
2062 Talbert Dr Ste 100
Location 11/33Chico, CA 95928-7718 · Phone (916) 351-9400 · Fax (916) 351-9449
2955 Main St Ste 110-K
Location 12/33Irvine, CA 92614-5909 · Phone (916) 351-9400 · Fax (916) 351-9449
4025 N Fresno St
Location 13/33Fresno, CA 93726-4026 · Phone (916) 351-9400 · Fax (916) 351-9449
1372 N Main St Ste 206-1
Location 14/33Walnut Creek, CA 94596-4692 · Phone (916) 351-9400 · Fax (916) 351-9449
509 13th St Ste 8
Location 15/33Modesto, CA 95354-2444 · Phone (916) 351-9400 · Fax (916) 351-9449
2222 Pacific Ave
Location 16/33Stockton, CA 95204-5334 · Phone (916) 351-9400 · Fax (916) 351-9449
44240 Fremont Blvd
Location 17/33Fremont, CA 94538-6000 · Phone (916) 351-9400 · Fax (916) 351-9449
634 H St
Location 18/33Eureka, CA 95501-1053 · Phone (916) 351-9400 · Fax (916) 351-9449
355 W Olive Ave Ste 3
Location 19/33El Centro, CA 92243-3043 · Phone (916) 351-9400 · Fax (916) 351-9449
55 Hitchcock Way Ste 209
Location 20/33Santa Barbara, CA 93105-5635 · Phone (916) 351-9400 · Fax (916) 351-9449
1825 N Oxnard Blvd Ste 19
Location 21/33Oxnard, CA 93030-3503 · Phone (916) 351-9400 · Fax (916) 351-9449
2345 Fletcher Pkwy
Location 22/33El Cajon, CA 92020-2134 · Phone (916) 351-9400 · Fax (916) 351-9449
1245 W 6th St
Location 23/33Corona, CA 92882-1870 · Phone (916) 351-9400 · Fax (916) 351-9449
225 W Hospitality Ln # 225201P
Location 24/33San Bernardino, CA 92408-3237 · Phone (916) 351-9400 · Fax (916) 351-9449
622 Jackson St Unit 103
Location 25/33Fairfield, CA 94533-6195 · Phone (916) 351-9400 · Fax (916) 351-9449
13500 W Airport Blvd Ste B
Location 26/33Sugar Land, TX 77498-6319 · Phone (310) 971-3103 · Fax (346) 450-6388
7177 Brockton Ave Ste 444A
Location 27/33Riverside, CA 92506-2635 · Phone (916) 351-9400 · Fax (916) 351-9449
888 4th St Ste 12
Location 28/33San Rafael, CA 94901-3284 · Phone (916) 351-9400 · Fax (916) 351-9449
2440 Professional Dr
Location 29/33Roseville, CA 95661-7773 · Phone (916) 351-9400 · Fax (916) 351-9449
5441 Aldrin Ct Ste A
Location 30/33Bakersfield, CA 93313-2194 · Phone (916) 351-9400 · Fax (916) 351-9449
7365 Carnelian St Ste 222F
Location 31/33Rancho Cucamonga, CA 91730-1157 · Phone (916) 351-9400 · Fax (916) 351-9449
2386 Fair Oaks Blvd
Location 32/33Sacramento, CA 95825-4741 · Phone (916) 351-9400 · Fax (916) 351-9449
9381 E Stockton Blvd Ste 220
Location 33/33Elk Grove, CA 95624-5070 · Phone (916) 351-9400 · Fax (916) 351-9449
Other Provider Identifiers 3
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
1032480 Other
Identifier 1/3State: TX · Issuer: Aprn-cnp
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
95062461 Other
Identifier 2/3State: CA · Issuer: Registetred Nurse
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
95017052 Other
Identifier 3/3State: CA · Issuer: Nurse Practitioner
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
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