Healthcare Provider Details

I. General information

NPI: 1043330657
Provider Name (Legal Business Name): JULIEANN AI-TE HSU RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST
LOMA LINDA CA
92354
US

IV. Provider business mailing address

26032 HINCKLEY ST
LOMA LINDA CA
92354-3946
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4000
  • Fax: 909-558-0696
Mailing address:
  • Phone: 909-796-4126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11391
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number11391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: