SearchCalifornia171W00000X

Larisa Kononov, ADMINISTRATOR

NPI 1760916811 · on the registry since 2017 · sole proprietor

Practice

Address
3620 Winona Way
North Highlands, CA 95660
Phone
(916) 628-9097
Fax
(916) 568-9752

Registry record

Primary taxonomy
171W00000X
171W00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2017-04-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California