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Organization
VERA ODEN
Active
Organization
VERA ODEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LUMPKIN (NA)
(510) 815-1565
Entity
Organization
Contact information
Practice address
900 IRON DR, VACAVILLE, CA 95687-7807
(707) 451-8365
Mailing address
900 IRON DR, VACAVILLE, CA 95687-7807
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 273802
CA
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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