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Individual

MRS. DEANNA LYNN DEFREITAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4662 LUCILLE DR, SAN DIEGO, CA 92115-1935
(619) 286-8538
Mailing address
4662 LUCILLE DR, SAN DIEGO, CA 92115-1935
(619) 286-8538

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C571894
CA

Other

Enumeration date
01/18/2007
Last updated
07/08/2007
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