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Individual

KARINA ACOSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
424 SONNET CT, OAKLEY, CA 94561-5086
(707) 720-6544
Mailing address
424 SONNET CT, OAKLEY, CA 94561-5086
(707) 720-6544

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
F4460536
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F4460536
ID
CA
Enumeration date
10/02/2019
Last updated
10/02/2019
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