Provider Demographics
NPI:1437555240
Name:HASSEN, FOZIA KAMIL (LVN)
Entity Type:Individual
Prefix:
First Name:FOZIA
Middle Name:KAMIL
Last Name:HASSEN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9383 WILLOW POND CIR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1266
Mailing Address - Country:US
Mailing Address - Phone:916-425-4622
Mailing Address - Fax:916-381-9026
Practice Address - Street 1:9383 WILLOW POND CIR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1266
Practice Address - Country:US
Practice Address - Phone:916-425-4622
Practice Address - Fax:916-381-9026
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 273359164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse