Active NPI
Olakunle Oredola, LVN
- Licensed Vocational Nurse
- Canoga Park, CA
National Provider Identifier
1922392158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN205424
- Practice address
- 22115 Roscoe Blvd.
Canoga Park, CA 91304-3839 - Phone
- (818) 884-8100
- Fax
- (818) 884-7808
- NPI assigned
- Jun 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | VN205424 | CA | Primary |
Addresses
Primary practice location
22115 Roscoe Blvd.
Canoga Park, CA 91304-3839
Mailing address
22115 Roscoe Blvd.
Canoga Park, CA 91304-3839
Phone (818) 884-8100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7283 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| VN205424 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307318400000",
"number": "1922392158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22115 ROSCOE BLVD.",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913043839",
"telephone_number": "818-884-8100",
"fax_number": "818-884-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22115 ROSCOE BLVD.",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913043839",
"telephone_number": "818-884-8100",
"fax_number": "818-884-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OREDOLA",
"first_name": "OLAKUNLE",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-06",
"last_updated": "2011-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN205424",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7283",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.