Provider Demographics
NPI:1477196269
Name:ASUMA, VILMA (RN)
Entity Type:Individual
Prefix:
First Name:VILMA
Middle Name:
Last Name:ASUMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VILMA
Other - Middle Name:A
Other - Last Name:BUMATAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1431 W 180TH ST
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3765
Mailing Address - Country:US
Mailing Address - Phone:662-402-3117
Mailing Address - Fax:
Practice Address - Street 1:1300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3505
Practice Address - Country:US
Practice Address - Phone:310-514-5359
Practice Address - Fax:310-514-5432
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA751745163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult