Facts
- Status
- A
- Credential
- LVN
- Type
- Individual
- Enumeration date
- 2019-08-02
- Last updated
- 2019-08-02
Specialties
Licenses
- License CA
- 262381
Location
- Practice location
- 8001 KELOK WAY
- City
- CLAYTON CA
- Postal code
- 945172037
- Phone
- 925-673-5442
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.