Individual
JESSICA DIANE VIALE
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
688 SUMMER ST # 2, FORTUNA, CA 95540-3045
(707) 845-1534
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95095572
CA
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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