Individual
KHAULA NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 CORPORATE WAY, SACRAMENTO, CA 95831-3875
(916) 395-4453
(916) 395-4454
Mailing address
1104 CORPORATE WAY, SACRAMENTO, CA 95831-3875
(916) 395-4453
(916) 395-4454
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
200708210359
CA
Other
Enumeration date
03/24/2017
Last updated
05/01/2017
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