MEDICARE: LUNIDE LOUIS ADEEKO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1447519459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUNIDE LOUIS ADEEKO

Provider Business Mailing Address
First Line	:	PO BOX 33568
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92163-3568
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:	619-374-7134

Provider Business Practice Location Address
First Line	:	5333 MISSION CENTER RD STE 110
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1347
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:	619-374-7134

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2012
Last Update Date	:	11/01/2024

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Directions to “ LUNIDE LOUIS ADEEKO ” Practice Location

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