Provider Demographics
NPI:1346027968
Name:TSUMA, REBECCA MWANDA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MWANDA
Last Name:TSUMA
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 1:20 DIANE CT
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-2786
Mailing Address - Country:US
Mailing Address - Phone:510-258-7322
Mailing Address - Fax:
Practice Address - Street 1:20 DIANE CT
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-2786
Practice Address - Country:US
Practice Address - Phone:510-258-7322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-08
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550995163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse