# LIBERTY PSYCHIATRY AND MENTAL HEALTH A PROFESSIONAL NURSING CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194454546
- **Authorized official:** OLUWATOYIN OGUNJALE NP (OWNER)
- **Authorized official phone:** (909) 635-5627

## Contact information

- **Practice address:** 6833 INDIANA AVE STE 208, RIVERSIDE, CA 92506-4223
- **Practice address phone:** (909) 635-5627
- **Mailing address:** 6833 INDIANA AVE STE 208, RIVERSIDE, CA 92506-4223
- **Mailing address phone:** (909) 635-5627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/09/2022
- **Last updated:** 06/09/2022