Individual
ELLEN GRACE S VO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 BLOSSOM WAY, HAYWARD, CA 94541-1986
(925) 819-2097
Mailing address
304 BLOSSOM WAY, HAYWARD, CA 94541-1986
(925) 819-2097
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95273850
CA
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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