Most Relevant Information
Provider Data
| NPI Number: | 1003524893 |
| Provider Name: | BLANCA E AVILA NP |
| Entity Type: | Individual |
| Taxonomy Code: | 163WG0000X |
| Specialty: | Registered Nurse |
| License Number: | 860482 |
Most Important Dates
| Enumeration Date: | 11/09/2022 |
| Last Updated: | 01/29/2024 |
Provider Practice Location
106 CHURCH ST STE 1
ROSEVILLE
CA
956782233
Practice Location Phone/Fax
| Phone: | 7144727942 |
| Fax: |
Provider Mailing Location
1164 FORMBY WAY
ROSEVILLE
CA
957476456
Provider Mailing Phone/Fax
| Phone: | 7144727942 |
| Fax: |