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Provider Information for 1609330778


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

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ADEKUNLE OLUREMI ILORI


Sex: Male

NPI: 1609330778
Last Updated: 2024-09-17
Certification Date: 2024-09-17

Details

NameValue
NPI1609330778
Enumeration Date2019-01-23
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 21101 DALE EVANS PKWY
APPLE VALLEY, CA 92307-9356
United States

Phone: 760-961-6720 | Fax:
 
Primary Practice Address 850 E FOOTHILL BLVD
RIALTO, CA 92376-5230
United States

Phone: 909-421-9233 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101Y00000X - Counselor CA102074
No 101YM0800X - Counselor - Mental HealthCA102074
Yes 1041C0700X - Social Worker - ClinicalCA125913