Individual
MISS MAYRA ALEJANDRA LARISSA POGGIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
160 W COCHRAN ST, SIMI VALLEY, CA 93065-6215
(180) 558-3227
Mailing address
160 W COCHRAN ST, SIMI VALLEY, CA 93065-6215
(180) 558-3227
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
OT17222
CA
Other
Enumeration date
04/17/2017
Last updated
10/12/2021
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