Individual
LATICIA MANTZOURANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 FAIRVIEW LN, SONORA, CA 95370-4809
(209) 536-2044
Mailing address
175 FAIRVIEW LN, SONORA, CA 95370-4809
(209) 536-2081
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
E0AE3D01D2
CA
Other
Enumeration date
07/08/2025
Last updated
07/11/2025
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