TAKARA DICKSON

FAIRFIELD, CA
NPI1184249146
Former NameTAKARA RAGLAND
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: CA  PA60134)
Additional Taxonomies363A00000X Physician Assistant
(Licence: CA  60134)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-06-15
Last Update Date2023-01-25
Business Address
TAKARA DICKSON PHYSICIAN ASSISTANT
1860 PENNSYLVANIA AVE CA STE 110
FAIRFIELD, CA 94533-3550
Phone number: 707-646-4414
Mailing Address
TAKARA DICKSON PHYSICIAN ASSISTANT
1860 PENNSYLVANIA AVE CA STE 110
FAIRFIELD, CA 94533-3550
Phone number: 707-646-4414