Active NPI
Abimbola A Popoola, N.P.
- Nurse Practitioner
- Van Nuys, CA
National Provider Identifier
1124577747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95004175
- Practice address
- 15211 Vanowen St
#209
Van Nuys, CA 91405-3606 - Phone
- (818) 997-1888
- NPI assigned
- Sep 23, 2016
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95004175 | CA | Primary |
Addresses
Primary practice location
15211 Vanowen St
#209
Van Nuys, CA 91405-3606
Mailing address
15211 Vanowen St
#209
Van Nuys, CA 91405-3606
Phone (818) 997-1888
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1124577747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15211 VANOWEN ST",
"address_2": "#209",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914053606",
"telephone_number": "818-997-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15211 VANOWEN ST",
"address_2": "#209",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914053606",
"telephone_number": "818-997-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPOOLA",
"first_name": "ABIMBOLA",
"middle_name": "A",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-23",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95004175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.