MS. JUDITH KOMATSU N.P L.A.C. NPI 1346261005

NPI Information

NPI: 1346261005
Provider Name: MS. JUDITH KOMATSU, N.P, L.A.C.
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
1179 N MCDOWELL BLVD
PETALUMA, CA
ZIP 94954
Phone: (707) 559-7500
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MS. Judith Komatsu, N.P, L.A.C. is an adult health nurse practitioner in Petaluma, CA with 13 years of experience. MS. Judith Komatsu, N.P, L.A.C. NPI is 1346261005. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1179 N MCDOWELL BLVD
PETALUMA, CA
ZIP 94954-559
Phone: (707) 559-7500
Fax: (707) 559-7620

The NPI 1346261005 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 7/6/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171100000X	Acupuncturist		CA7924	CALIFORNIA	No
2	363LA2200X	Nurse Practitioner	Adult Health	21030	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LA792H	OTHER	CALIFORNIA	ACUPUNTURIST

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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