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Individual

MRS. STACEY ALLISON SOUZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
275 BECK AVE MS 5240, FAIRFIELD, CA 94533-6804
(707) 784-8070
(707) 438-2500
Mailing address
275 BECK AVE MS 5240, FAIRFIELD, CA 94533-6804
(707) 784-8070
(707) 438-2500

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
444255
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
444255
REGISTERED NURSE
CA
Enumeration date
01/04/2007
Last updated
07/08/2007
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