Oluwaseun Boladale Ogunjimi, NURSE PRACTITIONER
Individual provider Active NPI Nurse Practitioner · Santa Ana, CA
NPI 1194243790 · NPPES record last updated Mar 28, 2019
Key facts
- NPI
- 1194243790
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- NP95006480 (CA)
- Practice address
- 3401 W Sunflower Ave Ste 250
Santa Ana, CA 92704 - Phone
- (888) 789-9585
- NPI assigned
- Sep 2, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Jefferson Medical College of Thomas Jefferson University, 2016
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Northeast Valley Health Corporation
Practice addresses (Care Compare)
14624 Sherman Way
FL 6
Van Nuys, CA 91405-2241
Phone (818) 988-6335
7107 Remmet Ave
Canoga Park, CA 91303-2016
Phone (818) 340-3570
7843 Lankershim Blvd
North Hollywood, CA 91605-2523
Phone (818) 826-5555
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190416001189 | CA | Practitioner - Nurse Practitioner | 4183965312 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP95006480 | CA | MD | Nurse Practitioner |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GN Medical Associates, Inc. | Family | Current |
Accepting new patients |
| Northeast Valley Health Corporation | Current |
Accepting new patients | |
| Northeast Valley Health Corporation | Current |
Accepting new patients | |
| Northeast Valley Health Corporation | Current | Accepting new patients | |
| Careconnectmd Ca PC | Current |
Accepting new patients | |
| Northeast Valley Health Corporation | Past | Accepting new patients |
Locations
7107 Remmet Ave
Canoga Park, CA 91303
Phone (818) 340-3570
3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182
7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656
12759 Van Nuys Blvd
Pacoima, CA 91331
Phone (818) 485-8250
12756 Van Nuys Blvd
Pacoima, CA 91331
Phone (818) 896-0531
1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388
3401 W Sunflower Ave
Ste 250
Santa Ana, CA 92704
Phone (714) 619-8777
3401 W Sunflower Ave
#250
Santa Ana, CA 92704
Phone (415) 848-8258
473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500
473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500
14624 Sherman Way
Fl 6
Van Nuys, CA 91405
Phone (818) 988-6335
14624 Sherman Way
Ste 600
Van Nuys, CA 91405
Phone (818) 988-6335
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- seun.ogunjimi.p1@direct.nevhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP95006480 | CA | |
| Nurse Practitioner | 363L00000X | NP95006480 | CA | Yes |
Addresses
Primary practice location
3401 W Sunflower Ave Ste 250
Santa Ana, CA 92704
Mailing address
3401 W Sunflower Ave Ste 250
Santa Ana, CA 92704-6948
Phone (888) 789-9585
Other practice location 1
17742 Aguamiel Rd
San Diego, CA 92127-1036
Phone (610) 931-4098
Other practice location 2
320 1st St N Ste 101
Jacksonville Beach, FL 32250-6956
Phone (866) 923-5038
Other providers in Santa Ana, CA
- Odyssey Healthcare Operating a LP
- Martin Eugen Offenberger
- Judy Roberta Ogan
- Delia V Ogawa
- Virgilus Mahakwe Ogbedeagu
- Christine P Oh
- Daniel Youngchul Oh
- Hangeal John Oh
- Joseph Saehan Oh
- Katherine Elizabeth Oien
All providers in Santa Ana, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.