Individual
EVA COOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4017 STEVENS ST, CASTRO VALLEY, CA 94546-4447
(510) 318-0503
Mailing address
4017 STEVENS ST, CASTRO VALLEY, CA 94546-4447
(510) 318-0503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
825880
CA
Other
Enumeration date
11/03/2023
Last updated
11/05/2023
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