Provider Demographics
NPI:1902301864
Name:AYINLA, JOSHUA IDOWU
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:IDOWU
Last Name:AYINLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22320 YORKE RD
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-2040
Mailing Address - Country:US
Mailing Address - Phone:951-588-9758
Mailing Address - Fax:
Practice Address - Street 1:22320 YORKE RD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-2040
Practice Address - Country:US
Practice Address - Phone:951-588-9758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-24
Last Update Date:2018-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst