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Individual

KATRIENA KALAILA VAN DE VELDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
590 RIO LINDO AVE, CHICO, CA 95926-1817
(530) 345-3491
Mailing address
7246 REMMET AVE, CANOGA PARK, CA 91303-1531
(818) 206-0360
(818) 206-0381

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
95030130
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D8683328
DRIVERS LICENSE
CA
Enumeration date
11/05/2019
Last updated
11/05/2019
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