NPI 1073137634

Andrea Banouvong

Practitioner Nurse Practitioner San Lorenzo, CA

Practice location

Address: 927 Via Honda, San Lorenzo, CA 94580-2815
Phone: (510) 407-0749

Registered specialties (2)

Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X Licence 95013507 (CA)

Other Nurse Practitioner providers in California →

Acute Care Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LA2100X Licence 95013507 (CA)

Registry record

NPI: 1073137634
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 May 2020
Record last updated: 29 May 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.