Individual
HARISSA ANDREA MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3924 BABSON DR, ELK GROVE, CA 95758-4579
(916) 716-6044
Mailing address
3924 BABSON DR, ELK GROVE, CA 95758-4579
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT15041TLG
CA
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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