Individual
STEVEN M LICEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9133 SAINT JAMES PL, WINDSOR, CA 95492-8332
(707) 480-1773
Mailing address
9133 SAINT JAMES PL, WINDSOR, CA 95492-8332
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
Primary
95188212
CA
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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