Organization
NEW AGE INFUSIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORNISE DENEE LOGAN-BERRY (OWNER)
(510) 415-5921
Entity
Organization
Contact information
Practice address
2545 TWIN CREEKS DR, SAN RAMON, CA 94583-1860
(510) 415-5921
Mailing address
2545 TWIN CREEKS DR, SAN RAMON, CA 94583-1860
(510) 415-5921
Taxonomy
Speciality
Code
Description
License number
State
163WI0600X
Infection Control Registered Nurse
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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