Individual
IMELDA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 S DEMAREE ST, VISALIA, CA 93277-3936
(559) 772-5762
Mailing address
1818 S DEMAREE ST, VISALIA, CA 93277-3936
(559) 772-5762
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
702508
CA
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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