Individual
KAVITA DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
230 JET STRM, TUSTIN, CA 92782-6525
(213) 675-1048
Mailing address
230 JET STRM, TUSTIN, CA 92782-6525
(213) 675-1048
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95000367
CA
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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