Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | NP95004991 | CA |
NPI | 1023497351 |
---|---|
Provider Name | Mrs. Opeyemi Adunni Bello |
First Address | Riverside, CA 92506-2506 |
Second Address | Riverside, CA 92506-2506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 12/10/2016 |