Individual
TANA KIRKHUFF COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2050 FAIRMONT DR, SAN LEANDRO, CA 94578-1001
(510) 483-3030
Mailing address
2275 ARLINGTON DR, SAN LEANDRO, CA 94578-1132
(510) 317-1444
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
744003
CA
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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