Individual provider Active NPI

John Olusanya Lajubutu

  • Licensed Psychiatric Technician
  • Fresno, CA
National Provider Identifier
1902620420
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
32919 Issued in CA
Practice address
4441 E Cesar Chavez Blvd
Fresno, CA 93702-3604
Phone
(559) 600-9180
NPI assigned
Nov 12, 2024
Last updated
Oct 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X 32919 CA Primary

Addresses

Primary practice location

4441 E Cesar Chavez Blvd
Fresno, CA 93702-3604

Mailing address

4441 E Cesar Chavez Blvd
Fresno, CA 93702-3604
Phone (559) 600-9180

Other practice location 1

3520 E Shields Ave Ste 102
Fresno, CA 93726-6923
Phone (559) 538-1230

Other practice location 2

3147 N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 453-1008

Other practice location 3

3127 N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 453-1008

Other practice location 4

3133B N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 453-1008

Other names 1

  • John Olusanya Lajubutu Other name

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
32919CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1902620420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3520 E Shields Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937266923",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3147 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3127 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3133B N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAJUBUTU",
        "first_name": "JOHN",
        "middle_name": "OLUSANYA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-12",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "32919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "LAJUBUTU",
            "middle_name": "OLUSANYA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.