Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 21365 | CA |
NPI | 1245779669 |
---|---|
Provider Name | Ms. Louise Tsukahara |
First Address | Los Angeles, CA 90064-2775 |
Second Address | Sacramento, CA 95817-2207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2017 |
Last Update Date | 17/02/2017 |