Provider Demographics
NPI:1548006273
Name:ADEAGBO, TAIYE
Entity type:Individual
Prefix:MS
First Name:TAIYE
Middle Name:
Last Name:ADEAGBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-5537
Mailing Address - Country:US
Mailing Address - Phone:310-508-2872
Mailing Address - Fax:
Practice Address - Street 1:1655 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-5537
Practice Address - Country:US
Practice Address - Phone:310-508-2872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula