Individual
CASEY QUINN L IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
950 W JULIAN ST, SAN JOSE, CA 95126-2719
(408) 292-9353
Mailing address
32364 PAYNE ST, HAYWARD, CA 94544-8166
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN702445
CA
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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