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Organization
WATERSIDE HEALTHCARE SERVICES INC
Active
Organization
WATERSIDE HEALTHCARE SERVICES INC
Active
Other names
WATERSIDE HEALTHCARE SERVICES INC
Organization subpart
No
Provider details
NPI number
Authorized official
TAIWO ODUKOYA ODUTOLA OWNER (NP)
(310) 927-2119
Entity
Organization
Contact information
Practice address
21880 ORRICK AVE, CARSON, CA 90745-3052
(310) 927-2119
Mailing address
21880 ORRICK AVE, CARSON, CA 90745-3052
(310) 927-2119
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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