Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tasha Rena Waller

Individual provider Registered Nurse · NPI 1952164105

Tasha Rena Waller is a Registered Nurse in Carson, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

16909 Belforest Dr
Carson, CA 90746-1112
Phone: (310) 404-3867
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 701821 (CA)

Record details

NPI number1952164105
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 31, 2024
Last updated in NPPESJanuary 31, 2024
Certification dateJanuary 31, 2024
Mailing address16909 Belforest Dr, Carson, CA 90746-1112

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