Individual
KASEY SOUVANNALEUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28289 BROKEN ARROW WAY, MURRIETA, CA 92563-9256
(619) 609-1616
Mailing address
29298 BROKEN ARROW WAY, MURRIETA, CA 92563-2721
(619) 609-1616
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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