Individual
ADEBUKOLA ELIZABETH OLUSANYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2940 INLAND EMPIRE BLVD, ONTARIO, CA 91764-4898
(909) 458-1350
(909) 579-8149
Mailing address
17965 CRABAPPLE CT, SAN BERNARDINO, CA 92407-0554
(909) 244-4313
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
749486
CA
363LF0000X
Family Nurse Practitioner
Primary
95017582
CA
Other
Enumeration date
01/23/2019
Last updated
09/29/2025
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