Individual
FAVEN MESFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
95232400
CA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
95021907
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111
—
CA
Enumeration date
09/27/2021
Last updated
12/27/2022
Update your record
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