Individual
GINA BOOMERSHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2270 DOUGLAS BLVD STE 216, ROSEVILLE, CA 95661-4239
(916) 782-1212
Mailing address
2270 DOUGLAS BLVD STE 216, ROSEVILLE, CA 95661-4239
(916) 782-1212
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
38883
CA
Other
Enumeration date
07/07/2006
Last updated
06/12/2013
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