Individual
BROOKE LYNN BANDILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3131 PALMER ST, SACRAMENTO, CA 95815-1412
(916) 921-6099
Mailing address
5101 OLEAN ST, FAIR OAKS, CA 95628-4030
(916) 966-4127
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/13/2010
Last updated
01/31/2011
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