Individual
CALISTA MAE VINYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 GOLD ST, REDDING, CA 96001-1958
(408) 512-7285
Mailing address
280 IRONWOOD LN, REDDING, CA 96003-5345
(408) 512-7285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A20042
CA
Other
Enumeration date
03/30/2019
Last updated
06/19/2023
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