Individual
MONTANA KNIGHTSBRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7101 BAIRD AVE, RESEDA, CA 91335-4150
(818) 342-5897
(818) 345-6356
Mailing address
7101 BAIRD AVE, RESEDA, CA 91335-4150
(818) 342-5897
(818) 345-6356
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
450123
CA
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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