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Individual
MRS. VICKI MARIE CLAVIN
Active
Individual
MRS. VICKI MARIE CLAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
563630
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EPS011920
MEDI-CAL PROVIDER NUMBER
CA
01
—
RVN001490
MEDI-CAL FAMILY TRAINING
CA
Enumeration date
05/03/2007
Last updated
07/08/2007
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