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Individual

CIENNA DESIRAE VASQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BSN, PHN

Contact information

Practice address
16980 S HARLAN RD, LATHROP, CA 95330-8738
(209) 953-0223
(209) 774-2570
Mailing address
PO BOX 2009, STOCKTON, CA 95201-2009
(209) 468-3400
(209) 774-2570

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/12/2025
Last updated
02/12/2025
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