Individual
STACEY MAI TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, RD
Contact information
Practice address
500 SANSOME ST STE 200, SAN FRANCISCO, CA 94111-3215
(888) 987-8337
Mailing address
920 VIA CARTAGO APT 45, RIVERSIDE, CA 92507-6296
(661) 932-6590
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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