Provider Demographics
NPI:1487527842
Name:OWOHA, HAMDAT ABIMBOLA
Entity type:Individual
Prefix:
First Name:HAMDAT
Middle Name:ABIMBOLA
Last Name:OWOHA
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 1:4603 TURNSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-1343
Mailing Address - Country:US
Mailing Address - Phone:678-851-0690
Mailing Address - Fax:
Practice Address - Street 1:4603 TURNSTONE WAY
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1343
Practice Address - Country:US
Practice Address - Phone:678-851-0690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2042957363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health