Individual
AUDRA DYAN MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10170 TORRANCE AVE, SAN JOSE, CA 95127-4154
(303) 910-8346
Mailing address
10170 TORRANCE AVE, SAN JOSE, CA 95127-4154
(303) 910-8346
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
819303
CA
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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