Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 95008090 | CA |
NPI | 1023483179 |
---|---|
Provider Name | Caitlin Giovanetti |
First Address | Annandale, VA 22003-1604 |
Second Address | Orange, CA 92868-4203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2015 |
Last Update Date | 17/03/2018 |