Provider Demographics
NPI:1396878278
Name:TARASUK, DENISE ARDYTHE (RN ND)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ARDYTHE
Last Name:TARASUK
Suffix:
Gender:F
Credentials:RN ND
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Other - First Name:
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Mailing Address - Street 1:51 E CAMPBELL AVE
Mailing Address - Street 2:SUITE 108F
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2047
Mailing Address - Country:US
Mailing Address - Phone:408-370-5291
Mailing Address - Fax:408-370-5293
Practice Address - Street 1:51 E CAMPBELL AVE
Practice Address - Street 2:SUITE 108F
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2047
Practice Address - Country:US
Practice Address - Phone:408-370-5291
Practice Address - Fax:408-370-5293
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAND-127175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath