Healthcare Provider Details

I. General information

NPI: 1366774853
Provider Name (Legal Business Name): RAVEN NOEL OYEDEJI ED.D, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 W CECIL AVE
DELANO CA
93215-1821
US

IV. Provider business mailing address

1201 24TH ST # B-110200
BAKERSFIELD CA
93301-2300
US

V. Phone/Fax

Practice location:
  • Phone: 510-375-8478
  • Fax:
Mailing address:
  • Phone: 510-375-8478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number100292
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY32740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: