Oyebola Omofadeke Oyelade

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95012789 Issued in CA

Practice address

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Phone

(281) 818-0667

NPI assigned

Oct 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Safe Havens PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grapevine, TX
  • NPI 1487425062
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1154964849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 MUSTANG DR STE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760511010",
            "telephone_number": "281-818-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "281-818-0667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2311 Mustang Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "76051",
            "country_code": "US",
            "telephone_number": "281-818-0667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2311 Mustang Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "76051",
            "country_code": "US",
            "telephone_number": "281-818-0667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1481 Windsor Dr",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924045416",
            "country_code": "US",
            "telephone_number": "909-275-3665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OYELADE",
        "first_name": "OYEBOLA",
        "middle_name": "OMOFADEKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61145520",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1019705",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95012789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Da Ouyang, MD
• Daniel Lee Ouyang, M.D.
• Jula Overturf Johnson, RN
• Joanne Rachelle Owings, LCSW
• Charles Owyang, M.D
• Adrian Glenn Pabayo, RRT
• Pacific Autism Center for Education
• Pacific Clinics
• Pacific Coast Anesthesia Inc
• Jorge Padilla

• Psychiatric/Mental Health Nurse Practitioner in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.