Healthcare Provider Details

I. General information

NPI: 1609496736
Provider Name (Legal Business Name): SINAT OYINKANSOLA ALEJE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1983 MARENGO ST
LOS ANGELES CA
90033-1370
US

IV. Provider business mailing address

1983 MARENGO ST
LOS ANGELES CA
90033-1370
US

V. Phone/Fax

Practice location:
  • Phone: 310-819-7740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95015776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: