Provider Demographics
NPI:1629305875
Name:WHITE-EMUZE, ADISHA ADENA
Entity Type:Individual
Prefix:
First Name:ADISHA
Middle Name:ADENA
Last Name:WHITE-EMUZE
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 1:169 E. ORANGE GROVE
Mailing Address - Street 2:8
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:748 1/2 VENTURA ST
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-4967
Practice Address - Country:US
Practice Address - Phone:323-357-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner