=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619886405
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANA YOUSEF HAMIDEH
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2026
-----------------------------------------------------
Last Update Date | 09/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 818 MAGNOLIA AVE
-----------------------------------------------------
City | CORONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92879-3128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-356-9992
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 924 HYDE PARK CT
-----------------------------------------------------
City | CORONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92881-6620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-356-9992
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC2100X
-----------------------------------------------------
Taxonomy Name | Continence Care Registered Nurse
-----------------------------------------------------
License Number | 95325804
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------