Healthcare Provider Details

I. General information

NPI: 1215473640
Provider Name (Legal Business Name): OLUKAYODE AKINKUNLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 EUCLID AVE # 200
NATIONAL CITY CA
91950-2951
US

IV. Provider business mailing address

125 HOOVER AVE
BLOOMFIELD NJ
07003-3858
US

V. Phone/Fax

Practice location:
  • Phone: 619-267-9257
  • Fax:
Mailing address:
  • Phone: 155-179-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61306590
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number404354
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95022264
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15036900
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number725270
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: