Individual
LARISSA N BOTCHARNIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1035 PLACER ST, REDDING, CA 96001-1125
(530) 246-5710
(530) 241-7838
Mailing address
PO BOX 992790, REDDING, CA 96099-2790
(530) 246-5710
(530) 241-7838
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP17636
CA
Other
Enumeration date
02/19/2007
Last updated
05/17/2012
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