=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043133358
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRECIOUS PEARL PSYCHIATRY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2026
-----------------------------------------------------
Last Update Date | 08/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 MARKET ST NE STE 101
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97301-2139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-282-7136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 217 PROMENADE WAY # 304
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77479-7280
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-282-7136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | OLAYEMI CYNTHIA AKINDELE
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 832-894-7736
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------