Individual
DR. TAI ODUSAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
25630 FELICIA AVE, MENIFEE, CA 92586-2376
(951) 772-6402
Mailing address
25630 FELICIA AVE, MENIFEE, CA 92586-2376
(951) 772-6402
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
01/07/2026
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