Basic Information
| Provider Information | |||||||||
| NPI: | 1194909929 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSUJI | ||||||||
| FirstName: | STELLA | ||||||||
| MiddleName: | UCHECHI | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | ONWUMERE | ||||||||
| OtherFirstName: | STELLA | ||||||||
| OtherMiddleName: | UCHECHI | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MICROBIOLOGIST | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5330 MONTEREY HWY APT H3 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951114213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4086615602 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2001 THE ALAMEDA SAN JOSE | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951261136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082617777 | ||||||||
| FaxNumber: | 4082549960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2007 | ||||||||
| LastUpdateDate: | 12/28/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.