Individual
NATHANIEL RABANG RAFANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1912 LAKESHORE DR, LODI, CA 95242-4232
(209) 612-6373
Mailing address
1912 LAKESHORE DR, LODI, CA 95242-4232
(209) 612-6373
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
808628
CA
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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