Individual
CARLA BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
900 FULTON AVE STE 205, SACRAMENTO, CA 95825-4517
(916) 484-3570
Mailing address
PO BOX 233335, SACRAMENTO, CA 95823-0438
(916) 267-1065
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN190633
CA
Other
Enumeration date
09/27/2016
Last updated
09/11/2023
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