Provider Demographics
NPI:1306924592
Name:HORIUCHI, KENI A (RN)
Entity type:Individual
Prefix:
First Name:KENI
Middle Name:A
Last Name:HORIUCHI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:405 WIGEON WAY
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-2045
Mailing Address - Country:US
Mailing Address - Phone:707-428-4875
Mailing Address - Fax:
Practice Address - Street 1:1860 PENNSYLVANIA AVE
Practice Address - Street 2:230
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3590
Practice Address - Country:US
Practice Address - Phone:707-429-6989
Practice Address - Fax:707-429-6978
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA320526364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology