Individual
CARSON COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
71 N MAIN ST, TEMPLETON, CA 93465-5326
(805) 434-2449
Mailing address
71 N MAIN ST, TEMPLETON, CA 93465-5326
(805) 434-2449
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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