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General NPI Number Information
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NPI Number | 1235901323
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Entity Type | Individual
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Provider Name | MS. TITILIA LEDUA
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 725 FARMERS LN STE 6
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City | SANTA ROSA
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State | CA
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Zip | 95405-6742
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Country | US
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Telephone | 707-889-9505
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Fax | 707-852-2113
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Provider Business Mailing Address
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Address Line | 725 FARMERS LN STE 6
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City | SANTA ROSA
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State | CA
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Zip | 95405-6742
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Country | US
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Telephone | 707-889-9505
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Fax | 707-852-2113
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 494700041
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License Number State | CA
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