Individual
PHALACIA LINDELL BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
240 BURT ST # 140, SANTA ROSA, CA 95407-6223
(323) 404-0705
Mailing address
240 BURT ST # 140, SANTA ROSA, CA 95407-6223
(323) 404-0705
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
757957
CA
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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