| NPI | 1508379553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JAMES STACY CEO 805-208-0434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NP15005) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2017-11-13 |