Individual
IVANA ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L E
Contact information
Practice address
1685 SAN PABLO AVE, PINOLE, CA 94564-2011
(510) 599-9505
Mailing address
4172 GARDEN RD, EL SOBRANTE, CA 94803-2229
(510) 599-9505
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
L9466
CA
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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