Individual
CAROL HABERCOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6955 FOOTHILL BLVD STE 188, OAKLAND, CA 94605-2455
(510) 388-1768
Mailing address
14360 HEMLOCK ST, SAN LEANDRO, CA 94579-1134
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
—
CA
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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