Provider Demographics
NPI:1043761950
Name:WOUBESHET, SINAY T
Entity Type:Individual
Prefix:
First Name:SINAY
Middle Name:T
Last Name:WOUBESHET
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 1:3910 W 59TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2920
Mailing Address - Country:US
Mailing Address - Phone:323-335-9630
Mailing Address - Fax:
Practice Address - Street 1:3910 W 59TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2920
Practice Address - Country:US
Practice Address - Phone:323-335-9630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator