Individual
LAURA JENSEN RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2092 LAKE TAHOE BLVD STE 500, SOUTH LAKE TAHOE, CA 96150-6429
(530) 600-1960
Mailing address
2092 LAKE TAHOE BLVD STE 500, S LAKE TAHOE, CA 96150-6429
(530) 600-1960
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
845484
NV
363L00000X
Nurse Practitioner
Primary
95019852
CA
Other
Enumeration date
01/27/2022
Last updated
04/07/2025
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