EKENEDILICHUKWU EZENWAKA NP
NPI 1669215000
Nurse Practitioner - Psychiatric/Mental Health in Stockton, CA

Q: What is Ekenedilichukwu Ezenwaka's NPI number?

The NPI number for Ekenedilichukwu Ezenwaka is 1669215000. It was assigned to this individual provider in the NPPES registry on June 14, 2024.

Q: What is Ekenedilichukwu Ezenwaka's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since June 14, 2024PECOS Enrolled

7707 AUSTIN RD, STOCKTON, CA 95215(209) 467-8655 Get Directions Write a Review

NPPES record last updated: June 14, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Ekenedilichukwu Ezenwaka Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EKENEDILICHUKWU EZENWAKA NP (NPI 1669215000) is an individual psychiatric/mental health provider in Stockton, California, licensed in California (95030565) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669215000

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameEKENEDILICHUKWU EZENWAKACredential: NP

Location Address7707 AUSTIN RDStockton, CA 95215-8312

Mailing Address6713 Sao Tiago WayElk Grove, CA 95757-3435 · (323) 973-6970

Phone(209) 467-8655

Sole ProprietorNo

Enumeration DateJune 14, 2024

NPPES CertifiedJune 14, 2024

✔ NPI 1669215000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95030565

7707 AUSTIN RD, Stockton, CA 95215

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ekenedilichukwu Ezenwaka Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95215 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE TAKLA PSYD

Psychologist (Clinical)