Healthcare Provider Details

I. General information

NPI: 1619886405
Provider Name (Legal Business Name): SANA YOUSEF HAMIDEH
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 MAGNOLIA AVE
CORONA CA
92879-3128
US

IV. Provider business mailing address

924 HYDE PARK CT
CORONA CA
92881-6620
US

V. Phone/Fax

Practice location:
  • Phone: 951-356-9992
  • Fax:
Mailing address:
  • Phone: 951-356-9992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License Number95325804
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: