Provider Demographics
NPI:1093532210
Name:OLADOJA, IKEOLUWA ADESIYAN
Entity type:Individual
Prefix:
First Name:IKEOLUWA
Middle Name:ADESIYAN
Last Name:OLADOJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HEGENBERGER RD STE 400
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1419
Mailing Address - Country:US
Mailing Address - Phone:510-834-2443
Mailing Address - Fax:
Practice Address - Street 1:303 HEGENBERGER RD STE 400
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1419
Practice Address - Country:US
Practice Address - Phone:510-834-2443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program