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Individual

MRS. ALIDA BERTHILA OUTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1600 BAYBERRY ST, HOLLISTER, CA 95023-8047
(760) 424-9172
Mailing address
1600 BAYBERRY ST, HOLLISTER, CA 95023-8047
(760) 424-9172

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
714346
CA

Other

Enumeration date
03/23/2013
Last updated
03/23/2013
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