Provider Demographics
NPI:1669183299
Name:OLUWATOYIN O OLADIMEJI DNP REGISTERED NURSING PRACTITIONER AP
Entity type:Organization
Organization Name:OLUWATOYIN O OLADIMEJI DNP REGISTERED NURSING PRACTITIONER AP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLADIMEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-582-3666
Mailing Address - Street 1:12658 DUTCH CT
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9279
Mailing Address - Country:US
Mailing Address - Phone:951-582-3512
Mailing Address - Fax:951-582-3512
Practice Address - Street 1:12658 DUTCH CT
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-9279
Practice Address - Country:US
Practice Address - Phone:951-582-3512
Practice Address - Fax:951-582-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty