Provider Demographics
NPI:1194315697
Name:ADEDURO, CHRISTIANAH OLUBUKOLA (MSN, FNP-C, PMHNP-BC)
Entity type:Individual
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First Name:CHRISTIANAH
Middle Name:OLUBUKOLA
Last Name:ADEDURO
Suffix:
Gender:F
Credentials:MSN, FNP-C, PMHNP-BC
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:550 W RANCHO VISTA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3011
Mailing Address - Country:US
Mailing Address - Phone:661-418-2889
Mailing Address - Fax:661-418-2892
Practice Address - Street 1:550 W RANCHO VISTA BLVD STE D
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3011
Practice Address - Country:US
Practice Address - Phone:661-418-2889
Practice Address - Fax:661-418-2889
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95016168363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily