Individual
JUDY MAE MAHAFFEY I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2379 SUNNYSIDE AVE, CLOVIS, CA 93611-4052
(559) 292-1403
Mailing address
2379 SUNNYSIDE AVE, CLOVIS, CA 93611-4052
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
384248
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
394248
RN
CA
05
—
EPS011820
—
CA
05
—
RVN000360
—
CA
Enumeration date
12/14/2006
Last updated
07/09/2007
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