Individual
MR. CAROL DIANE LA VAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN-C, FNP, MN, MAED
Contact information
Practice address
351 S HUDSON AVE, PASADENA, CA 91101-3507
(626) 795-6981
(626) 584-1540
Mailing address
11342 ORO VISTA AVE, SUNLAND, CA 91040-2031
(818) 353-9551
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN357592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SS1964881
—
AR
Enumeration date
03/01/2007
Last updated
07/09/2007
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