Provider Demographics
NPI:1245891050
Name:NKWUAKU, LOUISA (OTR/L)
Entity type:Individual
Prefix:
First Name:LOUISA
Middle Name:
Last Name:NKWUAKU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17606 RAINSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1518
Mailing Address - Country:US
Mailing Address - Phone:310-819-8187
Mailing Address - Fax:310-819-8187
Practice Address - Street 1:3435 W BALL RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3708
Practice Address - Country:US
Practice Address - Phone:714-827-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-23
Last Update Date:2019-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19887225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation