Individual
MARY CANDELARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4411 E KINGS CANYON, FRESNO, CA 93702
(559) 453-1008
Mailing address
4411 E KINGS CANYON RD, FRESNO, CA 93702
(559) 453-1008
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
288041
CA
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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