Active NPI
Modupe Onakoya
- Pharmacist
- Antioch, CA
National Provider Identifier
1235655143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 72238
- Practice address
- 3130 Buchanan Rd
Antioch, CA 94509-4427 - Phone
- (925) 754-5801
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 72238 | CA | Primary |
Addresses
Primary practice location
3130 Buchanan Rd
Antioch, CA 94509-4427
Mailing address
3130 Buchanan Rd
Antioch, CA 94509-4427
Other practice location 1
3130 Buchanan Rd
Antioch, CA 94509-4427
Phone (925) 754-5801
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 |
|---|---|---|---|
| 72238 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1235655143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3130 BUCHANAN RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945094427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 BUCHANAN RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945094427",
"telephone_number": "925-754-5801"
}
],
"practiceLocations": [
{
"address_1": "3130 Buchanan Rd",
"address_purpose": "LOCATION",
"city": "Antioch",
"state": "CA",
"postal_code": "945094427",
"country_code": "US",
"telephone_number": "925-754-5801",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ONAKOYA",
"first_name": "MODUPE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "72238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.