Healthcare Provider Details

I. General information

NPI: 1194290411
Provider Name (Legal Business Name): JOSEPHINE ASSINI-STRUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 12/01/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18000 STUDEBAKER RD STE 800
CERRITOS CA
90703-2671
US

IV. Provider business mailing address

18000 STUDEBAKER RD STE 800
CERRITOS CA
90703-2671
US

V. Phone/Fax

Practice location:
  • Phone: 562-735-3226
  • Fax:
Mailing address:
  • Phone: 562-735-3226
  • Fax: 562-869-1281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNPF95010097
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: