Healthcare Provider Details

I. General information

NPI: 1548938160
Provider Name (Legal Business Name): AYOMIDE HELEN ALLEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 08/02/2025
Certification Date: 08/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5256 BEACHFRONT COVE ST UNIT 206
SAN DIEGO CA
92154-5247
US

IV. Provider business mailing address

5256 BEACHFRONT COVE ST UNIT 206
SAN DIEGO CA
92154-5247
US

V. Phone/Fax

Practice location:
  • Phone: 619-565-9973
  • Fax:
Mailing address:
  • Phone: 619-565-9973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95032372
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95256458
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: