Individual
GINA LORENE WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1310 OLD WEST DR, SACRAMENTO, CA 95834-1411
(916) 204-3212
Mailing address
1310 OLD WEST DR, SACRAMENTO, CA 95834-1411
(916) 204-3212
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN198041
CA
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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