Individual
LYDIA MICHELE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3289 SWEETWATER SPRINGS BLVD APT 11, SPRING VALLEY, CA 91978-1061
(619) 735-5216
Mailing address
3289 SWEETWATER SPRINGS BLVD APT 11, SPRING VALLEY, CA 91978-1061
(619) 735-5216
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4564424
DRIVER LICENSE
CA
Enumeration date
02/02/2021
Last updated
02/02/2021
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