Individual
KATHLEEN V. GRISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
620 MONTEREY AVE, CAPITOLA, CA 95010-3618
(831) 464-5630
Mailing address
620 MONTEREY AVE, CAPITOLA, CA 95010-3618
(831) 464-5630
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
95056396
CA
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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