Individual
JUSTINA OBUKOKWO UGBIYOBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1703 HARKER CT, LATHROP, CA 95330-8245
(510) 584-1818
Mailing address
1703 HARKER CT, LATHROP, CA 95330-8245
(510) 584-1818
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
780490
CA
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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