Individual provider Active NPI

Olaitan Adepeju Subair

  • Licensed Vocational Nurse
  • Reseda, CA
National Provider Identifier
1003686734
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
732207 Issued in CA
Practice address
19609 Sherman Way Apt 201
Reseda, CA 91335-3430
Phone
(747) 253-8024
NPI assigned
Jan 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 732207 CA Primary

Addresses

Primary practice location

19609 Sherman Way Apt 201
Reseda, CA 91335-3430

Mailing address

19609 Sherman Way Apt 201
Reseda, CA 91335-3430
Phone (747) 253-8024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
732207CAMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1003686734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19609 SHERMAN WAY APT 201",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353430",
            "telephone_number": "747-253-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19609 SHERMAN WAY APT 201",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353430",
            "telephone_number": "747-253-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBAIR",
        "first_name": "OLAITAN",
        "middle_name": "ADEPEJU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "732207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.