Waterside Healthcare Services Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

WATERSIDE HEALTHCARE SERVICES INC

Doing business as

Waterside Healthcare Services Inc

Practice address

21880 Orrick Ave
Carson, CA 90745-3052

Phone

(310) 927-2119

NPI assigned

Dec 19, 2023

Last updated

Dec 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Taiwo Odukoya Odutola, OWNERNPI 1467178947

Title

NP

Phone

(310) 927-2119

Specialties & licenses 1

Addresses

Other names 1

• WATERSIDE HEALTHCARE SERVICES INC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Taiwo Odukoya Odutola, OWNER

  • Psychiatric/Mental Health Nurse Practitioner
  • Carson, CA
  • NPI 1467178947
  Authorized official Same address or phone

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

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1922876895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21880 ORRICK AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453052",
            "telephone_number": "310-927-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21880 ORRICK AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453052",
            "telephone_number": "310-927-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSIDE HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "ODUTOLA",
        "authorized_official_first_name": "TAIWO",
        "authorized_official_middle_name": "ODUKOYA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "310-927-2119",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATERSIDE HEALTHCARE SERVICES INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Marie Washington-Rowles
• Autumn Sholvhon Washington-Sandford
• Alexis Tarae Washington, LVN / NHA
• Greg Washington
• Latoya Washington
• Shianne Marie Watkins
• Beverly Webb
• Danielle Welihozkiy
• Wellcare Acupuncture, a PC
• Donald L. Wells, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Carson, CA
• Providers in Carson, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.