Individual
ALELI BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
625 5TH ST, SANTA ROSA, CA 95404-4428
(707) 565-4440
Mailing address
625 5TH ST, SANTA ROSA, CA 95404-4428
(707) 565-4440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95056635
CA
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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