Graduated: 2015
NPI: 1164897179
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
2280 HARRISON AVE, SUITE B
EUREKA, CA 955013200
7074439371
MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT
60 EASTER AVE
WEAVERVILLE, CA 960938054
5306235541
Source: CMS National Downloadable File, September 2026.