Provider Demographics
NPI:1336853225
Name:ONI, OPEYEMI
Entity type:Individual
Prefix:MRS
First Name:OPEYEMI
Middle Name:
Last Name:ONI
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 1:20418 VIA CELLINI
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4064
Mailing Address - Country:US
Mailing Address - Phone:323-428-2418
Mailing Address - Fax:
Practice Address - Street 1:5016 PARKWAY CALABASAS STE 212
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3900
Practice Address - Country:US
Practice Address - Phone:323-428-2418
Practice Address - Fax:213-668-5587
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CNS18395133N00000X
133NN1002X, 171400000X
MDDX5951133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8637814OtherUNITED HEALTHCARE