Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Sep 12, 2016
License(s)
95004954 (CA), NP95004954 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1999 MOWRY AVE STE A | Fremont, CA 94538-1757 | |
| LOCATION | 301 INDUSTRIAL RD | San Carlos, CA 94070-2603 | 650-596-4000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.