Most Relevant Information
Provider Data
| NPI Number: | 1003005190 |
| Provider Name: | ANDREA ROAD-TRAVELER LONGORIA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/15/2007 |
| Last Updated: | 10/15/2007 |
Provider Practice Location
518 LOW GAP RD
UKIAH
CA
954823735
Practice Location Phone/Fax
| Phone: | 7074634968 |
| Fax: |
Provider Mailing Location
518 LOW GAP RD
UKIAH
CA
954823735
Provider Mailing Phone/Fax
| Phone: | 7074634968 |
| Fax: |