Provider Demographics
NPI:1457010860
Name:OKE, ADEDUNTAN OLABISI (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ADEDUNTAN
Middle Name:OLABISI
Last Name:OKE
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3957 MIRECOURT CIR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6786
Mailing Address - Country:US
Mailing Address - Phone:215-687-5944
Mailing Address - Fax:
Practice Address - Street 1:3957 MIRECOURT CIR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6786
Practice Address - Country:US
Practice Address - Phone:215-687-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025384363L00000X, 363LP0808X
FL11016552363LP0808X
CANP95025384363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner