Individual
AUDRA DESIREE PACKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1705
(831) 462-7700
Mailing address
2760 EL CERRITO ST, SAN LUIS OBISPO, CA 93401-4671
(805) 781-0406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
63854
CA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/08/2023
Last updated
02/14/2024
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