Omobola Fashola

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

644419 Issued in CA

Practice address

14445 Olive View Dr
Sylmar, CA 91342-1437

Phone

(747) 210-4341

NPI assigned

Feb 8, 2021

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Mehboob Makhani MD a Professional CorporationGroup PAC ID 9133387442, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pacifica Hospital of the Valley Hospital, Sun Valley, CA, CCN 050378

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mehboob Makhani MD a Professional Corporation

  • Psychiatry Physician
  • Northridge, CA
  • NPI 1578835724
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pacifica of the Valley Corporation

  • General Acute Care Hospital
  • Sun Valley, CA
  • NPI 1548328750
  Care Compare affiliation

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1801488192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14659 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421652",
            "telephone_number": "818-485-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "747-210-4341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14659 Olive View Dr",
            "address_purpose": "LOCATION",
            "city": "Sylmar",
            "state": "CA",
            "postal_code": "913421652",
            "country_code": "US",
            "telephone_number": "818-485-0888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASHOLA",
        "first_name": "OMOBOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022795",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "644419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Dental Connection Inc.
• Basem Fanous, MD
• Leanne Zabala Farestveit, MD
• Farhadian Sylmar Dental Group, Inc.
• Funmilola Fashola, NP
• Payman Fathizadeh, M.D.
• Fawzy Tadros DDS.Inc
• Geraldine Mae Tiratira Feliciano
• Brianna Melissa Felix
• Christian Manuel Felix

• Registered Nurse in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.