Healthcare Provider Details

I. General information

NPI: 1023497351
Provider Name (Legal Business Name): OPEYEMI ADUNNI BELLO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3634 ELIZABETH ST
RIVERSIDE CA
92506-2506
US

IV. Provider business mailing address

3634 ELIZABETH ST
RIVERSIDE CA
92506-2506
US

V. Phone/Fax

Practice location:
  • Phone: 951-341-8930
  • Fax:
Mailing address:
  • Phone: 951-341-8930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP95004991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: