Provider Demographics
NPI:1154610061
Name:ASIODU, IFEYINWA (RN, PHN)
Entity type:Individual
Prefix:
First Name:IFEYINWA
Middle Name:
Last Name:ASIODU
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 ALAMEDA DE LAS PULGAS
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1269
Mailing Address - Country:US
Mailing Address - Phone:650-372-3234
Mailing Address - Fax:650-578-8939
Practice Address - Street 1:2415 UNIVERSITY AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1164
Practice Address - Country:US
Practice Address - Phone:650-363-3882
Practice Address - Fax:650-327-5238
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator