Individual
CHARLIE JOY JABONETE BALTAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
112 TOYON LN, VACAVILLE, CA 95687-3495
(707) 359-4612
Mailing address
112 TOYON LN, VACAVILLE, CA 95687-3495
(707) 359-4612
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
653695
CA
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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