Individual
BETHANY POPPENHAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 STANFORD WAY, SAUSALITO, CA 94965-2824
(432) 294-1181
Mailing address
144 STANFORD WAY, SAUSALITO, CA 94965-2824
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95058264
CA
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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