Provider Demographics
NPI:1366062598
Name:HOUSHMAND, TRINA KAMESH
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:KAMESH
Last Name:HOUSHMAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 CHRISTUS CT
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2033
Mailing Address - Country:US
Mailing Address - Phone:314-853-1194
Mailing Address - Fax:
Practice Address - Street 1:4219 CHRISTUS CT
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2033
Practice Address - Country:US
Practice Address - Phone:314-853-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health