Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Ezenwa, RN

Individual provider Psychiatric/Mental Health Registered Nurse · NPI 1003379959

Kenneth Ezenwa, RN is a Nurse Practitioner in Canyon Country, California. Qualified in 2020, 6 years ago. Practices with Inland Psychiatric Medical Group Inc, a 121-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2019
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

17467 Honey Maple St
Canyon Country, CA 91387-6870
Phone: (661) 212-5273
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95080178 (CA)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence 95080178 (CA)

Record details

NPI number1003379959
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorYes
NPI enumeratedApril 8, 2019
Last updated in NPPESFebruary 8, 2022
Certification dateFebruary 8, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Inland Psychiatric Medical Group Inc — 121 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Canyon Country