Individual
MRS. LISA HERSAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2279 45TH ST, SACRAMENTO, CA 95817-1514
(916) 734-5959
Mailing address
991 MOONLIT WAY, FOLSOM, CA 95630-7506
(916) 734-5959
Taxonomy
Speciality
Code
Description
License number
State
163WP0218X
Pediatric Oncology Registered Nurse
Primary
557147
CA
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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