Individual provider Active NPI

Temitayo Olagbemi, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1124545645
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95011030 Issued in CA
Practice address
446 Alta Rd # 5300
San Diego, CA 92158-3018
Phone
(619) 210-0385
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 95075817 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95011030 CA Primary

Addresses

Primary practice location

446 Alta Rd # 5300
San Diego, CA 92158-3018

Mailing address

446 Alta Rd
San Diego, CA 92158-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200220001980 OR Practitioner - Nurse Practitioner 4082040290 Reassigns benefits to 2 organizations
I20220420002237 CA Practitioner - Nurse Practitioner 4082040290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Union of Pan Asian CommunitiesGroup PAC ID 3476690801, 4 clinicians

Practice addresses (Care Compare)

3785 River Rd N
Keizer, OR 97303-4894
Phone (971) 533-8186

5348 University Ave
Suite 101
San Diego, CA 92105-8025
Phone (619) 229-2999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95075817CAMDGeneral Practice Registered Nurse
95011030CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Union of Pan Asian Communities CurrentSince Dec 8, 2021 Accepting new patients
Union of Pan Asian Communities CurrentSince Dec 8, 2021 Accepting new patients
Union of Pan Asian Communities Current Accepting new patients
Mtos Health LLC Psychiatric/Mental Health CurrentSince Jun 11, 2024 Accepting new patients
DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P CurrentSince Dec 18, 2019 Accepting new patients

Locations

1031 25th St
San Diego, CA 92102
Phone (619) 232-6454

5348 University Ave
Ste 101
San Diego, CA 92105
Phone (619) 229-2999

13203 SE 172nd Ave
Ste 166
Happy Valley, OR 97086
Phone (415) 812-6637

3785 River Rd N
Keizer, OR 97303
Phone (503) 383-9380

2600 Center St NE
Salem, OR 97301
Phone (503) 945-2800

Interoperability endpoints

  • Direct secure messaging: tolagbemi719822@direct.ochin.org

Organizations & group practices 5

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1124545645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921580001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 ALTA RD # 5300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921583018",
            "telephone_number": "619-210-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAGBEMI",
        "first_name": "TEMITAYO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95075817",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95011030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.