Individual
FELITA CARMONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 DOTHAN DR, MODESTO, CA 95357-1428
(650) 580-4971
Mailing address
3600 DOTHAN DR, MODESTO, CA 95357-1428
(650) 580-4971
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN225754
CA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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