Individual
MISS DEIDRA AULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
202 TEAK GROVE CT, SAN JOSE, CA 95123-1761
(253) 951-3528
Mailing address
202 TEAK GROVE CT, SAN JOSE, CA 95123-1761
(253) 951-3528
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
LR60475812
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144519
NBRC
WA
01
—
LR60475812
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
12/22/2015
Last updated
12/22/2015
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