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Individual

PAMELA JOAN SPAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1500 D ST RM 601, ANTIOCH, CA 94509-2346
(925) 777-9550
Mailing address
810 HAMILTON DR, PLEASANT HILL, CA 94523-3560
(925) 944-0916

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
164935
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
163WS0200X
R.N. SCHOOL
CA
Enumeration date
12/20/2006
Last updated
07/08/2007
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