Andrea Banouvong
NPI #1073137634 in San Lorenzo, California
Provider Information
- NPI Number
- 1073137634
- Entity Type
- Individual
- Name
- Andrea Banouvong
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- May 29, 2020
- Last Updated
- May 29, 2020
Practice Location
- Address
- 927 VIA HONDA
- City
- San Lorenzo
- State
- California
- ZIP Code
- 94580-2815
- Phone
- (510) 407-0749
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Acute Care — Acute Care |
| Nurse Practitioner |
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