Individual
BRANDI MICHELLE AZEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1360 GRAY AVE, APARTMENT B, YUBA CITY, CA 95991-3242
(530) 306-1896
Mailing address
PO BOX 586, CAMINO, CA 95709-0586
(530) 306-1896
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5527
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5527
CAS
CA
Enumeration date
03/23/2007
Last updated
07/08/2007
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