Provider Demographics
NPI:1336994532
Name:OLOWOOKERE, SUNDAY OLALEKAN (SUDCC, CADC, MBA)
Entity Type:Individual
Prefix:MR
First Name:SUNDAY
Middle Name:OLALEKAN
Last Name:OLOWOOKERE
Suffix:
Gender:M
Credentials:SUDCC, CADC, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 W IVESBROOK AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2594
Mailing Address - Country:US
Mailing Address - Phone:661-434-3709
Mailing Address - Fax:
Practice Address - Street 1:21101 DALE EVANS PKWY
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-9356
Practice Address - Country:US
Practice Address - Phone:760-961-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13581101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)