Individual
DEBORAH GAYLE THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1031
Mailing address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1031
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
RN276380
CA
Other
Enumeration date
12/01/2006
Last updated
02/11/2022
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