Individual
KIM BORBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3843 SACRAMENTO AVE, SANTA ROSA, CA 95405-8009
(707) 292-2394
Mailing address
2777 YULUPA AVE STE 611, SANTA ROSA, CA 95405-8584
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/20/2021
Last updated
01/27/2021
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