Provider Demographics
NPI:1831706563
Name:OSUMAH, LAMETU
Entity type:Individual
Prefix:
First Name:LAMETU
Middle Name:
Last Name:OSUMAH
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 1:3636 EDISON AVE APT 70
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2746
Mailing Address - Country:US
Mailing Address - Phone:916-807-2311
Mailing Address - Fax:
Practice Address - Street 1:7320 GRAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-1255
Practice Address - Country:US
Practice Address - Phone:916-847-0098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty