Individual
CAROLINA ODELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2588 CEDAR GROVE CT, CHULA VISTA, CA 91915-1544
(619) 316-2649
Mailing address
2588 CEDAR GROVE CT, CHULA VISTA, CA 91915-1544
(619) 316-2649
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A8623587
DRIVER LICENSE
CA
Enumeration date
10/22/2024
Last updated
10/22/2024
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