Individual
BENNETT ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 CAPITOL AVE, SACRAMENTO, CA 95816-5721
(916) 442-4985
Mailing address
2100 CAPITOL AVE, SACRAMENTO, CA 95816-5721
(916) 442-4985
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
688466
CA
Other
Enumeration date
07/05/2019
Last updated
05/20/2024
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