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General NPI Number Information
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NPI Number | 1114323755
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Entity Type | Individual
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Provider Name | OLAJUMOKE ADEYEMI
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Gender | Female
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 1225 W 190TH ST STE 280
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City | GARDENA
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State | CA
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Zip | 90248-4305
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Country | US
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Telephone | 805-650-3880
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Fax | 805-650-3887
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Provider Business Mailing Address
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Address Line | 1225 W 190TH ST STE 280
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City | GARDENA
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State | CA
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Zip | 90248-4305
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Country | US
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Telephone | 850-650-3880
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 842936
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95019346
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95019346
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95019346
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License Number State | CA
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