Healthcare Provider Details

I. General information

NPI: 1881503514
Provider Name (Legal Business Name): BELETSHACHEW F SENGENDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23890 COPPER HILL DR # 325
VALENCIA CA
91354-1701
US

IV. Provider business mailing address

23890 COPPER HILL DR # 325
VALENCIA CA
91354-1701
US

V. Phone/Fax

Practice location:
  • Phone: 818-515-6348
  • Fax:
Mailing address:
  • Phone: 818-515-6348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number742481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: