Ayodele Samuel Amadu

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

135219 Issued in CA

Practice address

14375 Nason St Ste 212
Moreno Valley, CA 92555-4730

Phone

(909) 272-6661

NPI assigned

Sep 19, 2023

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1982482261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923540419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14375 NASON ST STE 212",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554730",
            "telephone_number": "909-272-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADU",
        "first_name": "AYODELE",
        "middle_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-19",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "135219",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "135219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaura N/a Alvarez
• Jazlyn Alvarez
• Jodi Ellen Alvarez, BASW
• Lourdes Morelos Alvarez, DDS
• Santiago Alvarez, HMD. RCP.
• Dyrol Amantine
• Gina Elena Amaya, D.O.
• Amazing Angels Care Facility Inc.
• Amblacare LLC
• Amer a Jandali MD Inc

• Marriage & Family Therapist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.