Adebimpe Elizabeth Otegbola, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020923 Issued in CA

Practice address

625 Carnegie Dr Ste 120
San Bernardino, CA 92408-3577

Phone

(909) 383-2800

Fax

(909) 880-0439

NPI assigned

May 19, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1427795442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CARNEGIE DR STE 120",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083577",
            "telephone_number": "909-383-2800",
            "fax_number": "909-880-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CARNEGIE DR STE 120",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083577",
            "telephone_number": "909-383-2800",
            "fax_number": "909-880-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTEGBOLA",
        "first_name": "ADEBIMPE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.