Provider Demographics
NPI:1538979166
Name:OLADOKE, ABIOLA OLUFUNLAYO (PHD, MSHNFM, CLT)
Entity type:Individual
Prefix:DR
First Name:ABIOLA
Middle Name:OLUFUNLAYO
Last Name:OLADOKE
Suffix:
Gender:F
Credentials:PHD, MSHNFM, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MARY AVENUE
Mailing Address - Street 2:SUITE 2298
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444
Mailing Address - Country:US
Mailing Address - Phone:805-867-7298
Mailing Address - Fax:
Practice Address - Street 1:1447 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2250
Practice Address - Country:US
Practice Address - Phone:805-867-7298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171400000X
CA172M00000X, 174H00000X, 225700000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach
No172M00000XOther Service ProvidersMechanotherapist
No174H00000XOther Service ProvidersHealth Educator
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist