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General NPI Number Information
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NPI Number | 1164235172
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Entity Type | Individual
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Provider Name | JULIA MATSUMOTO BSN, RN, CCM
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Gender | Female
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | PSC 78 BUILDING 4408
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City | APO
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State | AP
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Zip | 96328
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Country | US
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Telephone | 42-552-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 404-1 KUMAGAWA MAISON MIYA 102
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City | FUSSA
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State | TOKYO
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Zip | 1970003
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Country | JP
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 95177278
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License Number State | CA
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