Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 95016160 | CA |
NPI | 1033792353 |
---|---|
Provider Name | Karen Ashley Cruz |
First Address | Glendale, CA 91204-1979 |
Second Address | Seaside, CA 93955-5720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2021 |
Last Update Date | 04/05/2021 |