Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 102L00000X | Psychologist | PSY31774 | CA |
N | 103T00000X | Psychologist | PSY31774 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | PSY31774 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY31774 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TP2701X | Group Psychotherapist | CA |
NPI | 1033623996 |
---|---|
Provider Name | Dr. Olabanji Adeniranye |
First Address | San Diego, CA 92112-0626 |
Second Address | San Diego, CA 92108-3846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2017 |
Last Update Date | 16/04/2020 |