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Individual

KEI JULIA VELAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
855 SEQUOIA CIR, FORT BRAGG, CA 95437-5466
(707) 964-1251
(707) 961-2722
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
1448
CA
363L00000X
Nurse Practitioner
11789
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11789
NURSE PRACTITIONER
CA
01
1448
NURSE MIDWIFE
CA
05
CMM71141F
CA
Enumeration date
09/21/2006
Last updated
12/30/2011
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