Provider Demographics
NPI:1912655937
Name:HANDROCK, KLARA MICHAEL (RN)
Entity Type:Individual
Prefix:MS
First Name:KLARA
Middle Name:MICHAEL
Last Name:HANDROCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KLARA
Other - Middle Name:MICHAEL
Other - Last Name:HANDROCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2428 PASO ROBLES ST
Mailing Address - Street 2:
Mailing Address - City:OCEANO
Mailing Address - State:CA
Mailing Address - Zip Code:93445-9117
Mailing Address - Country:US
Mailing Address - Phone:805-441-9423
Mailing Address - Fax:
Practice Address - Street 1:2180 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4558
Practice Address - Country:US
Practice Address - Phone:805-781-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA753139163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health