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Individual

LAILI FALATOONZADEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, CNM, WHNP

Contact information

Practice address
333 LAWS AVE, UKIAH, CA 95482-6540
(707) 468-1010
Mailing address
31723 HIGHWAY 128, CLOVERDALE, CA 95425-9445
(909) 260-6101

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95099659
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
95010469
CA
367A00000X
Advanced Practice Midwife
236003
CA

Other

Enumeration date
03/18/2015
Last updated
08/07/2019
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