Individual
CAYO KAWEAH ALBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, PMHNP-BC
Contact information
Practice address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
1942
CA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
95026401
CA
2084P0800X
Psychiatry Physician
Primary
95026401
CA
2084P0804X
Child & Adolescent Psychiatry Physician
95026401
CA
Other
Enumeration date
06/25/2011
Last updated
08/31/2023
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