Individual
LATASHA DENISE GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1504 PASEO AURORA, SAN DIEGO, CA 92154-4858
(619) 882-8464
Mailing address
1504 PASEO AURORA, SAN DIEGO, CA 92154-4858
(619) 882-8464
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
226763
CA
Other
Enumeration date
01/05/2011
Last updated
01/29/2016
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