Active NPI
Olufunke Olukoga
- Licensed Vocational Nurse
- Ceres, CA
National Provider Identifier
1124508007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 698088
- Practice address
- 1904 Richland Ave BLDG a
Ceres, CA 95307-4562 - Phone
- (209) 300-8800
- NPI assigned
- Aug 20, 2018
- Last updated
- Aug 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 698088 | CA | Primary |
Addresses
Primary practice location
1904 Richland Ave BLDG a
Ceres, CA 95307-4562
Mailing address
1517 Lynne Renee CT Apt B
Modesto, CA 95358-7229
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
| License | State | Type | Specialty |
|---|---|---|---|
| 698088 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1124508007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1517 LYNNE RENEE CT APT B",
"city": "MODESTO",
"state": "CA",
"postal_code": "953587229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1904 RICHLAND AVE BLDG A",
"city": "CERES",
"state": "CA",
"postal_code": "953074562",
"telephone_number": "209-300-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUKOGA",
"first_name": "OLUFUNKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "698088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ceres, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.