Healthcare Provider Details

I. General information

NPI: 1447101126
Provider Name (Legal Business Name): MAKEDA ROSHUN KAYODE REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2026
Last Update Date: 02/07/2026
Certification Date: 02/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8835 VANS ST
PARAMOUNT CA
90723-4656
US

IV. Provider business mailing address

2610 W BAYLOR CIR APT 105
ANAHEIM CA
92801-4908
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-5111
  • Fax:
Mailing address:
  • Phone: 323-396-4549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95049790
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: