Individual
THERESA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
415 E CHAPEL ST, SANTA MARIA, CA 93454-4517
(805) 928-5573
Mailing address
315 CASTAIC AVE, SHELL BEACH, CA 93449-1912
(805) 295-6128
Taxonomy
Speciality
Code
Description
License number
State
364SC1501X
Community Health/Public Health Clinical Nurse Specialist
Primary
17824
CA
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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