Individual provider Active NPI

Ayooluwa Abibat Odeyemi, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1043879190
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW105925 Issued in CA
Practice address
1750 Howe Ave Ste 300
Sacramento, CA 95825-3369
Phone
(916) 992-2620
Fax
(971) 352-4229
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW105925 CA Primary

Addresses

Primary practice location

1750 Howe Ave Ste 300
Sacramento, CA 95825-3369

Mailing address

2619 Patriot Dr
Lincoln, CA 95648-8858
Phone (818) 815-7301

Other names 1

  • Ayooluwa Abibat Bello Former name

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
LCSW105925CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. PastSince Jun 15, 2021 Accepting new patients
Guillaume Marriage and Family Counseling of California, P.C. PastSince Apr 1, 2025 Accepting new patients
Glenn Medical Center, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ayooluwa.bello.p1@direct.scfhc.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1043879190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 PATRIOT DR",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488858",
            "telephone_number": "818-815-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 HOWE AVE STE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253369",
            "telephone_number": "916-992-2620",
            "fax_number": "971-352-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEYEMI",
        "first_name": "AYOOLUWA",
        "middle_name": "ABIBAT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW105925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYOOLUWA",
            "last_name": "BELLO",
            "middle_name": "ABIBAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.