Provider Demographics
NPI:1457533382
Name:LOUNDON DSOUZA, TAMSEN CHARNA (FNP-C)
Entity Type:Individual
Prefix:
First Name:TAMSEN
Middle Name:CHARNA
Last Name:LOUNDON DSOUZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HOWE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4670
Mailing Address - Country:US
Mailing Address - Phone:916-972-1100
Mailing Address - Fax:916-972-1615
Practice Address - Street 1:701 HOWE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4670
Practice Address - Country:US
Practice Address - Phone:916-972-1100
Practice Address - Fax:916-972-1615
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ37088ZMedicare PIN