Individual
EDITH NUNGONG AMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 476-4012
Mailing address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 476-4012
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
709572
CA
164W00000X
Licensed Practical Nurse
314975
TX
Other
Enumeration date
10/15/2019
Last updated
04/30/2024
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