NPI | 1902389240 |
---|---|
Former Name | KRISTEEN HEREDERO CANDELARIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019188) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 847472) |
Enumeration Date | 2018-09-12 |
Last Update Date | 2024-10-09 |