Provider Demographics
NPI:1982364766
Name:TUFFOUR, OHENEBA KWAKU
Entity Type:Individual
Prefix:
First Name:OHENEBA
Middle Name:KWAKU
Last Name:TUFFOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 BELFONT CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1530
Mailing Address - Country:US
Mailing Address - Phone:916-912-7298
Mailing Address - Fax:
Practice Address - Street 1:319 BELFONT CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-1530
Practice Address - Country:US
Practice Address - Phone:916-912-7298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA590923163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse