Healthcare Provider Details

I. General information

NPI: 1861315038
Provider Name (Legal Business Name): OLUWATONI ADEROJU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 E JEFFERSON ST 445
PHOENIX AZ
85034
US

IV. Provider business mailing address

3747 S MAMMOTH DR
CASA GRANDE AZ
85193-7683
US

V. Phone/Fax

Practice location:
  • Phone: 602-341-5157
  • Fax:
Mailing address:
  • Phone: 415-819-7743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: