Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 95003059 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 95003059 | CA |
NPI | 1083085039 |
---|---|
Provider Name | Cindy Vu |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Santa Cruz, CA 95062-2239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2015 |
Last Update Date | 29/11/2018 |