Provider Demographics
NPI:1164210662
Name:KOUETEU, HELENE
Entity type:Individual
Prefix:
First Name:HELENE
Middle Name:
Last Name:KOUETEU
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 1:19914 GRAYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7610
Mailing Address - Country:US
Mailing Address - Phone:562-607-4795
Mailing Address - Fax:
Practice Address - Street 1:19914 GRAYLAND AVE
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-7610
Practice Address - Country:US
Practice Address - Phone:562-607-4795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN811199163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse