Provider Demographics
NPI:1033892591
Name:RASMUSON, ELLA SHEA
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:SHEA
Last Name:RASMUSON
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 1:229 E COMMONWEALTH AVE APT 228
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-4906
Mailing Address - Country:US
Mailing Address - Phone:970-381-3442
Mailing Address - Fax:
Practice Address - Street 1:229 E COMMONWEALTH AVE APT 228
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-4906
Practice Address - Country:US
Practice Address - Phone:970-381-3442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program