Individual
MARIEJOY B SUPAPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
275 BECK AVENUE MS 5-240, FAIRFIELD, CA 94533-6804
(707) 784-8070
(707) 435-2500
Mailing address
275 BECK AVENUE MS 5-240, FAIRFIELD, CA 94533-6804
(707) 784-8070
(707) 435-2500
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
607207
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607207
REGISTERED NURSE
CA
Enumeration date
01/03/2007
Last updated
07/08/2007
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