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General NPI Number Information
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NPI Number | 1457152985
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Entity Type | Individual
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Provider Name | IFEOLUWANI OLAYINKA ADESANYA
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Gender | Female
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 6609 BLANCO RD STE 145
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6179
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Country | US
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Telephone | 210-940-2764
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Fax | 830-239-9930
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Provider Business Mailing Address
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Address Line | 6609 BLANCO RD STE 145
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6179
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Country | US
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Telephone | 210-940-2764
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 971911
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1196724
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License Number State | TX
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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 | AP61683465
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License Number State | WA
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