Provider Demographics
NPI:1073064358
Name:OJEWOLE, JOHN KAYODE (LMFT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KAYODE
Last Name:OJEWOLE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DOUGLAS DR STE 140
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4078
Mailing Address - Country:US
Mailing Address - Phone:925-313-1155
Mailing Address - Fax:925-313-1142
Practice Address - Street 1:1420 WILLOW PASS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5823
Practice Address - Country:US
Practice Address - Phone:925-646-5480
Practice Address - Fax:925-646-5622
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 90816101YM0800X
390200000X
CA128530106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program