Individual
JESSE BEN PRIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 393-4000
Mailing address
901 RUSSELL AVE APT 121, SANTA ROSA, CA 95403-2691
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95001056
CA
Other
Enumeration date
02/21/2019
Last updated
01/03/2022
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