Individual
MRS. MAKERETA LEDUA HERESFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
78 CARLETON DR, PETALUMA, CA 94952-2254
(707) 774-9186
Mailing address
78 CARLETON DR, PETALUMA, CA 94952-2254
(707) 774-9186
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
494700050
CA
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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