Individual
DEMETRIA COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2085 E DAKOTA AVE, FRESNO, CA 93726-4804
(559) 453-4405
(559) 453-5111
Mailing address
3845 N CLARK ST STE 103, FRESNO, CA 93726-4812
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/26/2008
Last updated
07/08/2008
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