Individual
OMOWONUOLA OGUNWALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95092944
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95092944
RN
CA
Enumeration date
07/23/2018
Last updated
07/23/2018
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