DR. CHRYSTANYA A ADENIJI


Address: 514 N California Ave Ste 18, Beaumont, CA 92223-2120
Phone: 9517697733

DR. CHRYSTANYA A ADENIJI (NPI# 1760969562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760969562
Entity Type Individual
Full Name DR. CHRYSTANYA A ADENIJI
Credential DNP, PMHNP-BC
Practice Address 514 N California Ave Ste 18
Beaumont
CA 92223-2120
Mailing Address 1368 Oak St
Redlands
CA 92373-6868
Practice Telephone 9517697733
Mailing Telephone 9168444214
Enumeration Date 2018-07-24
Last Update Date 2019-06-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
95009539 CA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA NURSE PRACTITIONER LICENSE/FURNISHING 95009539 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
4960 Arlington Ave Ste B, Riverside, CA 92504 9513418930 9513418932
514 N California Ave Ste 18, Beaumont, CA 922232120 9517697733

Office Location

Street Address 514 N CALIFORNIA AVE STE 18
City BEAUMONT
State CA
Zip Code 92223-2120

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NPI Name Taxonomy Address Enumeration
1003479643 Living Hope Wellness Group, Inc Counselor 514 N California Ave Ste 18, Beaumont, CA 92223-2120 2019-04-18

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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1972934313 Kelly Sparkman Nurse Practitioner 2750 S 8th St, Beaumont, TX 77701-7719 2013-12-11
1780931154 Bethanne Fondren Carson Nurse Practitioner 3560 Delaware St, Suite 502, Beaumont, TX 77706-3067 2012-08-05

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Competitor

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City BEAUMONT
Zip Code 92223

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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