Omotayo O Alamutu, DNP, FNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

19624 Issued in CA

Practice address

103 Bodin Cir
Travis Afb, CA 94535-1801

Phone

(707) 908-5630

NPI assigned

Jan 5, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: omotayo.alamutu.2@9357.direct.athenahealth.com
• Direct secure messaging: omotayo.alamutu.1@9357.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mellow Medical Inc a Professional Corporation

  • Psychiatry Physician
  • West Hollywood, CA
  • NPI 1407275886

  CA

  Medicare reassignment NPD
• Telecare Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1720164882
  NPD

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1689978652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 512",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351801",
            "telephone_number": "707-908-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAMUTU",
        "first_name": "OMOTAYO",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "19624",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "19624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Jeffrey Agirre, DDS, MS
• Theresa Agosto-Smart
• Min Ji Ahn
• Hiroko Akuzawa, M.D.
• Riyadh Zihraw Al-Jammaly, MD
• Rey Cadagat Alba, M.D.
• Ann Elizabeth Alexander, DMD, MS
• Percy Sylvester Alexander Jr., PTA
• Douglas Alfar, M.D.
• John Allis, MD

• All providers in Travis Afb, CA
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.