Individual
CAROL ANN REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 EMELINE AVE, SANTA CRUZ, CA 95060-1966
(831) 454-4335
Mailing address
1060 EMELINE AVE, SANTA CRUZ, CA 95060-1966
(831) 454-4335
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
307958
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70042F
FQHC
CA
Enumeration date
08/20/2007
Last updated
08/20/2007
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