Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | CA |
NPI | 1114241759 |
---|---|
Provider Name | Dr. Theresa Dale |
First Address | Oxnard, CA 93035 |
Second Address | Oxnard, CA 93035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2010 |
Last Update Date | 25/03/2010 |