Individual
KATHERINE NICOLE SAN ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2220 GIRARD ST, SAN JACINTO, CA 92583-5301
(951) 683-6596
Mailing address
11483 AARON AVE, BEAUMONT, CA 92223-6263
(909) 693-6209
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
283211
CA
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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