Basic Information
| Provider Information | |||||||||
| NPI: | 1487790069 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SENDEKU | ||||||||
| FirstName: | YESALEMUSH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | RN DNS CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 710 SOUTH BROADWAY, SUITE 300 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252954145 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1425 SOUTH MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252955477 | ||||||||
| FaxNumber: | 9252955226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 240907 | CA | X | Nursing Service Providers | Registered Nurse | 364S00000X | 569 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
No ID Information.