Provider Demographics
NPI:1154382216
Name:SOJOBI, ANGELA ONOSOLABOMI (CNM)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:ONOSOLABOMI
Last Name:SOJOBI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12980 FREDERICK ST
Mailing Address - Street 2:STE A
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5263
Mailing Address - Country:US
Mailing Address - Phone:951-924-0108
Mailing Address - Fax:951-924-4776
Practice Address - Street 1:12980 FREDERICK ST
Practice Address - Street 2:SUITE A
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-5263
Practice Address - Country:US
Practice Address - Phone:951-924-0108
Practice Address - Fax:951-924-4776
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1019176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW010191Medicaid
CANMW010190Medicaid