Individual
THERESA WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12930 GASTON DR, NEVADA CITY, CA 95959-9524
(530) 470-2425
Mailing address
145 GLASSON WAY, GRASS VALLEY, CA 95945
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN233284
CA
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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