Individual
AMENDA LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(599) 624-2000
Mailing address
12448 ORANGEBLOSSOM LN, RIVERSIDE, CA 92503-7057
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
82710
CA
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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