Individual
KASAMA BRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1706 DESCANSO AVE, SAN MARCOS, CA 92078-2514
(760) 280-2230
Mailing address
1706 DESCANSO AVE, SAN MARCOS, CA 92078-2514
(760) 280-2230
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
95030595
CA
Other
Enumeration date
06/12/2024
Last updated
06/19/2025
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