Individual
COURLETT BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
265 S ANITA DR STE 102-104, ORANGE, CA 92868-3355
(714) 410-3505
Mailing address
265 S ANITA DR STE 102-104, ORANGE, CA 92868-3355
(714) 410-3505
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
235505
CA
Other
Enumeration date
05/06/2025
Last updated
05/06/2025
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