Individual
IDA RUTH LUNDSTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CD(DONA)
Contact information
Practice address
6075 CAROLINDA DR, GRANITE BAY, CA 95746-9437
(916) 718-8826
Mailing address
6075 CAROLINDA DR, GRANITE BAY, CA 95746-9437
(916) 718-8826
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
374J000000
NURSING SERVICES RELATED PROVIDER
—
Enumeration date
01/26/2011
Last updated
01/26/2011
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