Individual
ALFREDO JAVIER AGUSTIN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3950 BRISTLEWOOD WAY, SACRAMENTO, CA 95823-6241
(916) 428-0743
Mailing address
3950 BRISTLEWOOD WAY, SACRAMENTO, CA 95823-6241
(916) 428-0743
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
225095
CA
Other
Enumeration date
08/24/2017
Last updated
07/21/2022
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