Individual
LISA MICHELLE ANDRADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 W HOSPITAL RD, FRENCH CAMP, CA 95231-9693
(209) 953-5424
Mailing address
10100 TRINITY PKWY STE 100, STOCKTON, CA 95219-7239
(209) 953-5424
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
501791
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94-3040535
SAN JOAQUIN HEALTH CLINICS
CA
Enumeration date
09/07/2022
Last updated
09/07/2022
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