Individual
MRS. JUSTINE E WALDRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.
Contact information
Practice address
4251 S HIGUERA ST STE 300, SAN LUIS OBISPO, CA 93401-7741
(805) 994-0074
Mailing address
4251 S HIGUERA ST STE 300, SAN LUIS OBISPO, CA 93401-7741
(805) 994-0074
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM 406
CA
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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