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Individual

MRS. CHRISTINA LYNN GANDOLFO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1167 E PAUL AVE, FRESNO, CA 93710-4023
(559) 447-8847
Mailing address
1167 E PAUL AVE, FRESNO, CA 93710-4023
(559) 447-8847

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
626247
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
EPS015920
MEDI-CAL
CA
01
RVN004130
MEDI-CAL
CA
Enumeration date
11/02/2007
Last updated
11/02/2007
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