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Individual

MS. KATHLEEN NONE GUSKY-SHARP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
105 VISTA VIEW DR, 105 VISTA VIEW DR.,, CLOVERDALE, CA 95425-3373
(707) 894-7409
Mailing address
105 VISTA VIEW DR, 105 VISTA VIEW DR.,, CLOVERDALE, CA 95425-3373
(707) 894-7409

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CAOT#12
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CA 12
NBCOT AA060681
CA
Enumeration date
11/20/2006
Last updated
06/27/2011
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