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Individual

DENISE ROCHELLE RANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7225 E SOUTHGATE DR STE D, SACRAMENTO, CA 95823-2651
(916) 394-1000
Mailing address
3909 ELLENBORO AVE, MODESTO, CA 95357-1443
(209) 409-0977

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
712378
CA

Other

Enumeration date
07/01/2021
Last updated
07/01/2021
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