Individual
MRS. TATIANA MUDRENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(877) 457-4772
Mailing address
2555 NEWCASTLE RD, NEWCASTLE, CA 95658-9751
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
01/11/2022
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