Individual
CHANEL LIGSAY BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2100 CAPITOL AVE, SACRAMENTO, CA 95816-5721
(916) 442-4985
Mailing address
1436 COLUMBUS RD, WEST SACRAMENTO, CA 95691-4918
(916) 402-0681
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
707453
CA
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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