Individual provider Active NPI

Nimota Olayinka Aleje

  • Psychiatric/Mental Health Nurse Practitioner
  • Culver City, CA
National Provider Identifier
1275190472
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95014192 Issued in CA
Practice address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone
(562) 290-2961
NPI assigned
May 22, 2019
Last updated
Sep 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95014192 CA Primary

Addresses

Primary practice location

4760 Sepulveda Blvd
Culver City, CA 90230-4820

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (562) 459-4947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20221115003209 CA Practitioner - Nurse Practitioner 5991173387 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95014192CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Care Health Group CurrentSince Nov 28, 2023 Accepting new patients
KCS, Inc. CurrentSince Jul 20, 2022 Accepting new patients
KCS, Inc. CurrentSince Jul 20, 2022 Accepting new patients
Serenity Care Health Group CurrentSince Nov 28, 2023 Accepting new patients

Locations

451 W Lincoln Ave
Ste 100
Anaheim, CA 92805
Phone (704) 503-6550

7212 Orangethorpe Ave
Ste 9A
Buena Park, CA 90621
Phone (714) 449-1125

19742 MacArthur Blvd
Ste 250
Irvine, CA 92612
Phone (714) 449-1339

1930 E Anaheim St
Long Beach, CA 90813
Phone (562) 478-4102

515 S Flower St
Fl 18
Los Angeles, CA 90071
Phone (310) 748-8142

Interoperability endpoints

  • Direct secure messaging: nimota.aleje.p1@direct.kcs.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1275190472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "562-459-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "562-290-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEJE",
        "first_name": "NIMOTA",
        "middle_name": "OLAYINKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95014192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.