Provider Demographics
NPI:1548810344
Name:ONWUVUARIRI, PETER DAMIAN CHUKWUEMEKA
Entity type:Individual
Prefix:
First Name:PETER DAMIAN
Middle Name:CHUKWUEMEKA
Last Name:ONWUVUARIRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 BUCHANAN RD APT 112
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4494
Mailing Address - Country:US
Mailing Address - Phone:925-325-2650
Mailing Address - Fax:
Practice Address - Street 1:3101 BUCHANAN RD APT 112
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4494
Practice Address - Country:US
Practice Address - Phone:925-325-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician