Individual
ADRIENNE CHELSEY LIDRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 3RD ST APT 205W, SANTA ROSA, CA 95404-4561
(707) 907-1626
Mailing address
1050 3RD ST APT 205W, SANTA ROSA, CA 95404-4561
(707) 907-1626
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
372500000X
Chore Provider
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
374U00000X
Home Health Aide
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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