Individual
DESTINY RAE RAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 W G ST, LOS BANOS, CA 93635-3657
(209) 381-6800
(209) 725-3963
Mailing address
545 M ST, LOS BANOS, CA 93635-4234
(209) 752-4823
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
CA
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
06/19/2023
Last updated
06/09/2025
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