Individual
WELTHY NORIVA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 W WOODLAND AVE, WOODLAND, CA 95695-2541
(707) 999-8305
Mailing address
311 W WOODLAND AVE, WOODLAND, CA 95695-2541
(707) 999-8305
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTHER
COMMUNITY CARE
CA
Enumeration date
09/13/2019
Last updated
09/13/2019
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