| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KELSEY HIDESHIMA | 1366066292 | 2022-05-08 |
Kelsey Hideshima is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1366066292. Registration indicates Kelsey Hideshima is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Kelsey Hideshima |
| Practice Office Address | 4860 Y ST STE 1700 SACRAMENTO, CA US |
| Practice Office Telephone | 9167342700 |
| Mailing Address | 4860 Y ST STE 1700 SACRAMENTO, CA 958172307 US |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |