Healthcare Provider Details

I. General information

NPI: 1821405283
Provider Name (Legal Business Name): ADEBOWALE ARSHAD NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADEBOWALE (WALE) ADENIJI NP

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 FRANKLIN ST STE OAKLAND
OAKLAND CA
94612-3210
US

IV. Provider business mailing address

1404 FRANKLIN ST STE 200
OAKLAND CA
94612-3208
US

V. Phone/Fax

Practice location:
  • Phone: 415-535-3310
  • Fax:
Mailing address:
  • Phone: 415-535-3310
  • Fax: 510-601-3973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95003802
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number834153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: