Individual
VIRGINIA POP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3734 HOLLISTER AVE, CARMICHAEL, CA 95608-2834
(916) 944-8163
Mailing address
3734 HOLLISTER AVE, CARMICHAEL, CA 95608-2834
(916) 944-8163
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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