Healthcare Provider Details

I. General information

NPI: 1922849694
Provider Name (Legal Business Name): AROMANCE LIFE INSTITUTE OF HOLISTIC & COMPREHENSIVE HEALTH&NURSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARBOR DR STE 300
SAUSALITO CA
94965-1434
US

IV. Provider business mailing address

272 BAY VISTA CIR
SAUSALITO CA
94965-1038
US

V. Phone/Fax

Practice location:
  • Phone: 760-284-4493
  • Fax: 415-727-9353
Mailing address:
  • Phone: 760-284-4493
  • Fax: 760-727-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH UDOR
Title or Position: CEO
Credential: FNP
Phone: 760-284-4493