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1124586755
GISSELLE E SUAZO
PETALUMA, CA
NPI
1124586755
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95011197)
Enumeration Date
2019-03-02
Last Update Date
2022-08-19
Business Address
GISSELLE E SUAZO
1179 N MCDOWELL BLVD
PETALUMA, CA 94954-6559
Phone number: 707-559-7617
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Mailing Address
GISSELLE E SUAZO
2185 PACHECO ST
CONCORD, CA 94520-2309
Phone number: 925-676-0505
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