Individual
LESLIE CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
830 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-7400
(209) 558-8315
Mailing address
830 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-7400
(209) 558-8315
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
815637
CA
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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