Individual
TARA VANDERPOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6767 GREEN VALLEY RD, PLACERVILLE, CA 95667-8984
(530) 919-0656
Mailing address
6767 GREEN VALLEY RD, PLACERVILLE, CA 95667-8984
(530) 919-0656
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
632713
CA
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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