Provider Demographics
NPI:1043879190
Name:ODEYEMI, AYOOLUWA ABIBAT (LCSW)
Entity type:Individual
Prefix:
First Name:AYOOLUWA
Middle Name:ABIBAT
Last Name:ODEYEMI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AYOOLUWA
Other - Middle Name:ABIBAT
Other - Last Name:BELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2619 PATRIOT DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8858
Mailing Address - Country:US
Mailing Address - Phone:818-815-7301
Mailing Address - Fax:
Practice Address - Street 1:1750 HOWE AVE STE 300
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3369
Practice Address - Country:US
Practice Address - Phone:916-992-2620
Practice Address - Fax:971-352-4229
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1059251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical