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Individual

BETTY LETICIA CERVANTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
108 W VICTORIA ST, GARDENA, CA 90248-3523
(310) 715-2020
Mailing address
16700 MARYGOLD AVE APT 145, FONTANA, CA 92335-6659
(626) 500-6185

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
CA

Other

Enumeration date
12/29/2017
Last updated
12/29/2017
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