Graduated: 2008
NPI: 1023151065
Practice Locations (3)
REDDING RANCHERIA
1441 LIBERTY ST
REDDING, CA 960010811
53022427001740
353 PARK MARINA CIR
REDDING, CA 960010965
5303561864
PO BOX, SUITE 990273
REDDING, CA 960990273
Source: CMS National Downloadable File, September 2026.