Provider Demographics
NPI:1770394926
Name:OGUNLEYE, OLUWATOYIN ELIZABETH
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:ELIZABETH
Last Name:OGUNLEYE
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 1:12909 CORDARY AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-9305
Mailing Address - Country:US
Mailing Address - Phone:714-770-7830
Mailing Address - Fax:
Practice Address - Street 1:12909 CORDARY AVE APT 20
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-9305
Practice Address - Country:US
Practice Address - Phone:714-770-7830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
CA376K00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide