Individual
CARLY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 CLUB DR, VALLEJO, CA 94592-1187
(707) 638-5200
Mailing address
141 SKYWAY DR, VALLEJO, CA 94591-4026
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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