Individual
TASHA TAKESHITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
255 E BONITA AVE, POMONA, CA 91767-1933
(909) 450-0304
Mailing address
1301 W PROVIDENCE AVE, ORANGE, CA 92868-3808
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU3672
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AU3672
AUDIOLOGY LICENSE
CA
Enumeration date
12/21/2021
Last updated
09/13/2024
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