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Individual

TIASSA LENA POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
250 HOSPITAL PKWY, SAN JOSE, CA 95119-1103
(408) 972-3000
Mailing address
255 9TH AVE APT 715, OAKLAND, CA 94606-5139
(510) 325-0708

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95001408
CA

Other

Enumeration date
09/30/2020
Last updated
03/28/2022
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