Individual provider Active NPI

Mary Simisola Ogunmeru, PHARMD

  • Pharmacist
  • Willits, CA
National Provider Identifier
1053275834
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
91386 Issued in CA
Practice address
3 Marcela Dr.
Willits, CA 95490
Phone
(707) 456-3005
NPI assigned
Dec 15, 2025
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 91386 CA Primary

Addresses

Primary practice location

3 Marcela Dr.
Willits, CA 95490

Mailing address

2601 McBride LN Apt 18
Santa Rosa, CA 95403-2733

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
91386CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1053275834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 MCBRIDE LN APT 18",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MARCELA DR.",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "95490",
            "telephone_number": "707-456-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNMERU",
        "first_name": "MARY",
        "middle_name": "SIMISOLA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "91386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willits, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.