Individual
DESIREE GRACE RICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19367 VICTORY BLVD STE 14, TARZANA, CA 91335-6302
(818) 343-8116
Mailing address
1920 LUCAS ST UNIT 2, SAN FERNANDO, CA 91340-1668
(303) 875-9459
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA8374
CA
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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