Individual
ANGELA ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 S AUBURN ST, GRASS VALLEY, CA 95945-7222
(530) 802-1095
Mailing address
504 S AUBURN ST, GRASS VALLEY, CA 95945-7222
(530) 802-1095
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN 272908
CA
Other
Enumeration date
11/21/2015
Last updated
11/21/2015
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