Individual provider Active NPI

Omozele Oiyemhonlan

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1538851035
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95048564 Issued in CA
Practice address
900 Fulton Ave Ste 205
Sacramento, CA 95825-4517
Phone
(916) 484-3570
NPI assigned
May 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95048564 CA Primary

Addresses

Primary practice location

900 Fulton Ave Ste 205
Sacramento, CA 95825-4517

Mailing address

213 W Limerick Ave
Mountain House, CA 95391-8318
Phone (510) 604-8026

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

LicenseStateTypeSpecialty
95048564CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1538851035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W LIMERICK AVE",
            "city": "MOUNTAIN HOUSE",
            "state": "CA",
            "postal_code": "953918318",
            "telephone_number": "510-604-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FULTON AVE STE 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254517",
            "telephone_number": "916-484-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OIYEMHONLAN",
        "first_name": "OMOZELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95048564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.