Provider Demographics
NPI:1992469464
Name:OLADEJO, ENIOLA ABIMBOLA (LVN)
Entity type:Individual
Prefix:
First Name:ENIOLA
Middle Name:ABIMBOLA
Last Name:OLADEJO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 ROSE AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6556
Mailing Address - Country:US
Mailing Address - Phone:925-577-6606
Mailing Address - Fax:
Practice Address - Street 1:421 ROSE AVE APT 5
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6556
Practice Address - Country:US
Practice Address - Phone:925-577-6606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA720769164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse