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General NPI Number Information
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NPI Number | 1013216258
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Entity Type | Individual
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Provider Name | MR. JUSTIN ALEXANDER DEW
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Gender | Male
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Dates
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Enumeration Date | 03/25/2011
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Last Update Date | 03/25/2011
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Provider Practice Location Address
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Address Line | 867 OXFORD CT
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City | YUBA CITY
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State | CA
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Zip | 95991-3479
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Country | US
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Telephone | 916-860-9356
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Fax |
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Provider Business Mailing Address
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Address Line | 867 OXFORD CT
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City | YUBA CITY
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State | CA
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Zip | 95991-3479
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Country | US
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Telephone | 916-860-9356
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 45-1081076
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License Number State | CA
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