Provider Demographics
NPI:1821738824
Name:ABELLANA, NATSUMI
Entity Type:Individual
Prefix:
First Name:NATSUMI
Middle Name:
Last Name:ABELLANA
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 1:10424 ALBERT DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4585
Mailing Address - Country:US
Mailing Address - Phone:209-561-7448
Mailing Address - Fax:
Practice Address - Street 1:10424 ALBERT DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-4585
Practice Address - Country:US
Practice Address - Phone:209-561-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95276727163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse