Provider Demographics
NPI:1487211157
Name:SONTEYA, NETSAI
Entity Type:Individual
Prefix:
First Name:NETSAI
Middle Name:
Last Name:SONTEYA
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 1:1317 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-3206
Mailing Address - Country:US
Mailing Address - Phone:562-900-7608
Mailing Address - Fax:
Practice Address - Street 1:1317 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-3206
Practice Address - Country:US
Practice Address - Phone:562-900-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025517163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical