MEDICARE: MRS. SIDONIE HELENE MASSA TUECHE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	812247	CA

General Provider Information

NPI Number	:	1841073046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SIDONIE HELENE MASSA TUECHE

Provider Business Mailing Address
First Line	:	217 STAR DREAM CT
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95747-4790
Country	:	US
Telephone Number	:	530-220-5089
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 STAR DREAM CT
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95747-4790
Country	:	US
Telephone Number	:	530-220-5089
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	02/18/2026

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