Individual
LARISSA MICHELE OBERHOLTZER-GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2 REGENCY DR, CLAYTON, CA 94517-1715
(925) 693-0545
(925) 693-0545
Mailing address
2 REGENCY DR, CLAYTON, CA 94517-1715
(925) 693-0545
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
562922
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
888
NOT APPLICABLE
—
Enumeration date
01/13/2021
Last updated
01/13/2021
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