Individual
MISS KATHY SOUMOUNTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
427 CABO CT, OCEANSIDE, CA 92058-7997
(704) 488-9659
Mailing address
427 CABO CT, OCEANSIDE, CA 92058-7997
(704) 488-9659
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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