Provider Demographics
NPI:1528606670
Name:ADEYINKA, OLUWASEYI
Entity Type:Individual
Prefix:
First Name:OLUWASEYI
Middle Name:
Last Name:ADEYINKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3846 S SILVER OAK WAY
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-3865
Mailing Address - Country:US
Mailing Address - Phone:626-251-7391
Mailing Address - Fax:909-259-8832
Practice Address - Street 1:3846 S SILVER OAK WAY
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-3865
Practice Address - Country:US
Practice Address - Phone:626-251-7391
Practice Address - Fax:909-259-8832
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-47251103K00000X
CA1-21-47251103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst