Individual
THERESA LYNN BOLOGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1701 MISSION AVE, SUITE A, OCEANSIDE, CA 92058-7102
(760) 967-4475
(760) 966-3827
Mailing address
1701 MISSION AVE, SUITE A, OCEANSIDE, CA 92058-7102
(760) 967-4475
(760) 966-3827
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
369409
CA
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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