Provider Demographics
NPI:1609531979
Name:NOORI, ASMA
Entity Type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:NOORI
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 1:2132 TENNIS LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-1166
Mailing Address - Country:US
Mailing Address - Phone:209-914-8736
Mailing Address - Fax:
Practice Address - Street 1:2132 TENNIS LN
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-1166
Practice Address - Country:US
Practice Address - Phone:209-914-8736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95263478163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse