Individual
MRS. MAHALIA MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,FNP
Contact information
Practice address
4649 VICTORIA PARK CT, FREMONT, CA 94538-4057
(601) 946-6675
Mailing address
4649 VICTORIA PARK CT, FREMONT, CA 94538-4057
(601) 946-6675
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
579704
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
579704
BOARD OF NURSING
CA
Enumeration date
01/25/2019
Last updated
01/25/2019
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