OLATUNDE OMOLEYE OWOEYE (NPI# 1487165817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487165817 |
| Entity Type | Individual |
| Full Name | OLATUNDE OMOLEYE OWOEYE |
| Practice Address |
15230 Lakeshore Dr Clearlake CA 95422-8107 |
| Practice Telephone | 7079954500 |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2018-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 47608 | RI | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95009059 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN01705 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15230 LAKESHORE DR |
| City | CLEARLAKE |
| State | CA |
| Zip Code | 95422-8107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770580268 | Lake Health Services | Pharmacy | 15230 Lakeshore Dr, Clearlake, CA 95422 | 2005-06-30 |
| 1386254134 | Jaykumar Maradia | Registered Nurse | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2020-08-06 |
| 1730710617 | Veronica Garcia Arroyo | Community Health Worker | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2020-01-30 |
| 1407494818 | Thomas Pickett | Physician Assistant | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2019-12-16 |
| 1962043174 | Srikanth Mudumba | Pharmacist | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2019-09-30 |
| 1780140046 | Rommel B Gayagoy | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2019-02-12 |
| 1972084879 | Trina Chung | Dentist | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2018-08-28 |
| 1558849661 | Sonja Derose | Family Medicine | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2018-07-31 |
| 1255838603 | Crystine L'heraux | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422 | 2018-04-11 |
| 1760997951 | Tammy Ezinne Onu | Physician Assistant | 15230 Lakeshore Dr, Clearlake, CA 95422 | 2017-12-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831729201 | Richard Charles Hammond | Counselor | 7000 B South Center Drive, Clearlake, CA 95422 | 2020-01-24 |
| 1609416437 | Junirose Thom | Behavioral Analyst | 4456 Manzanita Avenue Suite 2, Clearlake, CA 95422 | 2020-01-09 |
| 1649781360 | Lake County Office of Education | Local Education Agency (LEA) | 3350 Acacia St, Clearlake, CA 95422 | 2017-10-20 |
| 1083091326 | Noelle Menesini | Physician Assistant | 15230 Lake Shore Drive, Clearlake, CA 95422 | 2015-05-06 |
| 1861820979 | Lake County Office of Education | Local Education Agency (LEA) | 6945 Old Highway 53, Clearlake, CA 95422 | 2013-10-29 |
| 1124469838 | Hassan Sheikh Moghaddas | Surgery | 15332 Lakeshore Dr Ste 101, Clearlake, CA 95422 | 2013-07-10 |
| 1366710279 | Nancy Bylund | Licensed Psychiatric Technician | 7000b South Center Drive, Clearlake, CA 95422 | 2011-12-06 |
| 1699060830 | Planned Parenthood Shasta Pacific | Clinic/Center | 1437 Olympic Drive, Cleaklake, CA 95422 | 2011-06-16 |
| 1164655247 | Hector Lara | Counselor | 14130 Lakeshore Dr., Clearlake, CA 95422 | 2009-08-24 |
| 1518197607 | Vishal V Desai | Pharmacist | 15025, Olympic Drive, Clearlake, CA 95422 | 2009-07-23 |
| Find all providers in zip 95422 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927608 | Stephenie Hargrove | Nurse Practitioner | 15630 18th Ave, Clearlake, CA 95422-9336 | 2020-09-18 |
| 1255838603 | Crystine L'heraux | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422 | 2018-04-11 |
| 1720597339 | Ciaran George Carroll | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422 | 2017-09-26 |
| 1447654751 | Rebecca Luisa Sedillo | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2014-10-15 |
| 1306149240 | Ann C Larocca | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2010-12-15 |
| 1902066764 | Julie Payette | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2008-06-13 |
| 1134393069 | Katherine Robin Willems | Nurse Practitioner | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 | 2008-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003640 | Samira Kadri | Nurse Practitioner | 431 S Burnside Ave Apt 3g, Los Angeles, CA 90036-5343 | 2020-11-08 |
| 1801497706 | Ana Maria Cajigas De Jesus | Nurse Practitioner | 313 S Velva Pl, Anaheim, CA 92804-2647 | 2020-11-06 |
| 1609477421 | Taylor Mcknight | Nurse Practitioner | 5073 Oxford Dr, Cypress, CA 90630-3653 | 2020-11-06 |
| 1619578465 | Roslyn Dykes-barrow | Nurse Practitioner | 17631 Mulberry Dr, Carson, CA 90746-7403 | 2020-11-06 |
| 1861093601 | Philana P Mcdonald | Nurse Practitioner | 183 Stonebridge Ln, Paso Robles, CA 93446-1926 | 2020-11-06 |
| 1386245264 | Annie Parikh | Nurse Practitioner | 11675 Lambert Ave, El Monte, CA 91732-1955 | 2020-11-05 |
| 1073114096 | Blanca De Jesus Serrano | Nurse Practitioner | 18144 Outer Hwy 18 Ste 200, Apple Valley, CA 92307-2212 | 2020-11-05 |
| 1578164166 | Aimon Sangwanpanich | Nurse Practitioner | 8520 Shirley Ave, Northridge, CA 91324-4149 | 2020-11-02 |
| 1043810757 | Casie Lee Mcguire | Nurse Practitioner | 1826 Rainbow Terrace Ln, Montebello, CA 90640-1953 | 2020-10-30 |
| 1295335099 | Jail Lopez | Nurse Practitioner | 3171 Lynwood Rd, Lynwood, CA 90262-4118 | 2020-10-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.