| Theo Ikele, NP | |
|
16260 Ventura Blvd Ste 630, Encino, CA 91436-2255 | |
| (747) 998-0387 | |
| Not Available |
| Full Name | Theo Ikele |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 7 Years |
| Location | 16260 Ventura Blvd Ste 630, Encino, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871088518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | NP95008566 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | Hospital |
| Providence Little Co Of Mary Med Ctr San Pedro | San pedro, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pismo Wellness Inc A Professional Medical Corporation | 3274907134 | 5 |
| Alliance For Wellness Inc | 9931355617 | 32 |
| Entity Name | Alliance For Wellness Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124329131 PECOS PAC ID: 9931355617 Enrollment ID: O20120813000228 |
| Entity Name | Pismo Wellness Inc A Professional Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841765674 PECOS PAC ID: 3274907134 Enrollment ID: O20230428000080 |
| Mailing Address | Practice Location Address |
|---|---|
| Theo Ikele, NP 16260 Ventura Blvd Ste 630, Encino, CA 91436-2255 Ph: (747) 998-0387 | Theo Ikele, NP 16260 Ventura Blvd Ste 630, Encino, CA 91436-2255 Ph: (747) 998-0387 |
Heidi Collier, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16133 Ventura Blvd, #360, Encino, CA 91436 Phone: 818-986-6009 Fax: 818-396-5594 | |
Carrie Elizabeth Wilson Friedman, RN,MSN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16055 Ventura Blvd, Suite 712, Encino, CA 91436 Phone: 818-386-1395 Fax: 888-882-6061 | |
Maya King, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16133 Ventura Blvd Ste 360, Encino, CA 91436 Phone: 818-986-6009 Fax: 818-239-4239 | |
John Tonegato, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16260 Ventura Blvd Ste 140, Encino, CA 91436 Phone: 818-528-2500 | |
Kelly Michele Manda, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5363 Balboa Blvd Ste 245, Encino, CA 91316 Phone: 818-343-4430 Fax: 818-343-4423 | |
Rome Diostonne Evangelista, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16530 Ventura Blvd Ste 400, Encino, CA 91436 Phone: 818-625-4814 | |
Kristi Lynn Kuiken, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15503 Ventura Blvd Ste 240, Encino, CA 91436 Phone: 818-461-8148 Fax: 818-461-8105 |