Individual
LISA GAYE QUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN CDE
Contact information
Practice address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5305
(510) 727-3032
(510) 583-7624
Mailing address
19250 CLEMENT DR, CASTRO VALLEY, CA 94552-5040
(510) 502-0090
(510) 583-7624
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN351114
CA
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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