Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 95009894 | CA |
NPI | 1033691316 |
---|---|
Provider Name | Sasinee Jade Bhosai |
First Address | Santa Monica, CA 90403-1808 |
Second Address | Glendora, CA 91741-4207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2018 |
Last Update Date | 07/11/2019 |