Individual
JULIA A GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12811 COVEY CIR, SONORA, CA 95370-5935
(209) 588-8840
(209) 588-0911
Mailing address
13989 STANTON CIR, SONORA, CA 95370-8641
(209) 588-5584
(209) 588-0911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP5485
CA
Other
Enumeration date
12/21/2005
Last updated
11/18/2016
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