Individual provider Active NPI

Ebony Adagun

  • Perinatal Registered Nurse
  • Carson, CA
National Provider Identifier
1831059120
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Perinatal Registered NurseTaxonomy code 163WP1700X
License
95324454 Issued in CA
Practice address
21800 Avalon Blvd Unit 442
Carson, CA 90745-2459
Phone
(909) 446-2556
NPI assigned
Nov 18, 2025
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perinatal Registered Nurse 163WP1700X 95324454 CA Primary

Addresses

Primary practice location

21800 Avalon Blvd Unit 442
Carson, CA 90745-2459

Mailing address

21800 Avalon Blvd Unit 442
Carson, CA 90745-2459

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
95324454CAMDPerinatal Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1831059120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21800 AVALON BLVD UNIT 442",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21800 AVALON BLVD UNIT 442",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452459",
            "telephone_number": "909-446-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAGUN",
        "first_name": "EBONY",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP1700X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Perinatal",
            "state": "CA",
            "license": "95324454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.