Individual
MISS GRACE ELEANOR AMARALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2523 WESTBERRY DR, SANTA ROSA, CA 95403-4183
(707) 544-4703
Mailing address
2523 WESTBERRY DRIVE, SANTA ROSA, CA 95403-4183
(707) 544-4703
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN467219
CA
171M00000X
Case Manager/Care Coordinator
RVN004520
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN467219
REGISTERED NURSE
CA
01
—
RVN004520
DEPARTMENT OF HEALTH
CA
Enumeration date
10/18/2007
Last updated
10/18/2007
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