Individual
CLARIZA L AGUILLON-DOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
632 W GIBSON RD, WOODLAND, CA 95695-5169
(530) 669-3261
Mailing address
632 W GIBSON RD, WOODLAND, CA 95695-5169
(530) 669-3261
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP19828
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FK624Z
PTAN
CA
Enumeration date
07/21/2010
Last updated
03/29/2012
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