Individual
LAURA MAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
632 W GIBSON RD, WOODLAND, CA 95695-5169
(530) 419-1219
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95010965
CA
Other
Enumeration date
01/29/2019
Last updated
05/13/2019
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