Individual
ALISON RAE TICKENOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1950 E 17TH ST, SANTA ANA, CA 92705-6852
(714) 547-5375
Mailing address
1950 E 17TH ST, SANTA ANA, CA 92705-6852
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
259207
CA
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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