Individual
DENITA CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
409 TALMAGE RD, UKIAH, CA 95482-5956
(707) 234-0086
Mailing address
415 WASHO DR, UKIAH, CA 95482-5136
(707) 272-5873
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
D3943985
CA
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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