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General NPI Number Information
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NPI Number | 1063981496
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Entity Type | Individual
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Provider Name | MR. HAKEEM MICHAEL WATKINS-OLADUNJOYE
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Gender | Male
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 1301 PINE AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3124
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Country | US
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Telephone | 562-794-5965
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Fax |
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Provider Business Mailing Address
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Address Line | 1697 GRAND AVE
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City | LONG BEACH
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State | CA
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Zip | 90804-2714
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Country | US
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Telephone | 408-660-0701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APCC5698
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT109657
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 128069
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License Number State | CA
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