Provider Demographics
NPI:1740931369
Name:YAKUBU, OLUWAYEMISI A
Entity type:Individual
Prefix:
First Name:OLUWAYEMISI
Middle Name:A
Last Name:YAKUBU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OLUWAYEMISI
Other - Middle Name:A
Other - Last Name:KADIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15329 VOSE ST APT 212
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5248
Mailing Address - Country:US
Mailing Address - Phone:323-327-6977
Mailing Address - Fax:
Practice Address - Street 1:15329 VOSE ST APT 212
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-5248
Practice Address - Country:US
Practice Address - Phone:323-327-6977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker