Individual
DEBRA JEAN PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
4103 THOMAS DR, LAKEPORT, CA 95453-9302
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95064626
CA
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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