Individual
DEOGRACIA BANO MENTION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 SPARROW DR, GALT, CA 95632-2446
(916) 214-9281
Mailing address
7240 E SOUTHGATE DR STE G, SACRAMENTO, CA 95823-2627
(916) 391-4293
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN242497
CA
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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