Individual
MS. ASA B. THORVALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 17TH ST, OAKLAND, CA 94612-4124
(510) 238-5020
(510) 261-3584
Mailing address
280 17TH ST, OAKLAND, CA 94612-4124
(510) 238-5020
(510) 261-3584
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
761278
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1411033663
EMPLOYER ID NUMBER
CA
Enumeration date
09/01/2010
Last updated
09/01/2010
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