Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANDREA BANOUVONG
Active Sole ProprietorANDREA BANOUVONG is a Nurse Practitioner healthcare provider located in SAN LORENZO, California. NPI 1073137634 is currently active in the NPPES registry. Verify at CMS.
Nurse Practitioner · SAN LORENZO, CA
Registration Details
- NPI Number
- 1073137634
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 29, 2020 (6.2416473442642 yrs)
- Last Updated
- May 29, 2020
- Licenses
-
95013507 (CA)95013507 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
927 VIA HONDASAN LORENZO, CA, 945802815Browse CA providers · Browse ZIP 94580
- Phone
- 5104070749
- Primary Specialty
-
Nurse Practitioner
363L00000X
- Additional Specialty
- Nurse Practitioner
Other Nurse Practitioner Providers in SAN LORENZO, CA
| Name | Credential | NPI |
|---|---|---|
| MS. KAREN GOLD | NP | 1003023946 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.