Randall Duke Lealofi Wendt Olo, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN95336194 Issued in CA

Practice address

28641 Highpoint Ave
Moreno Valley, CA 92555-7002

Phone

(951) 207-8575

NPI assigned

Nov 27, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Randall Duke Olo Lealofi Safotu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1700652369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28641 HIGHPOINT AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925557002",
            "telephone_number": "951-207-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28641 HIGHPOINT AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925557002",
            "telephone_number": "951-207-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT OLO",
        "first_name": "RANDALL",
        "middle_name": "DUKE LEALOFI",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "RN95336194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDALL",
            "last_name": "SAFOTU",
            "middle_name": "DUKE OLO LEALOFI",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Adult Psychiatric/Mental Health Registered Nurse in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.