Provider Demographics
NPI:1144620402
Name:KASKOWITZ, SOMMER RAE (FNP)
Entity Type:Individual
Prefix:MS
First Name:SOMMER
Middle Name:RAE
Last Name:KASKOWITZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5970 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90001-1150
Mailing Address - Country:US
Mailing Address - Phone:323-234-3280
Mailing Address - Fax:323-234-3493
Practice Address - Street 1:5970 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90001-1150
Practice Address - Country:US
Practice Address - Phone:323-234-3280
Practice Address - Fax:323-234-3493
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-23
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily