Individual
LATY SHERMAINE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2275 S MAIN ST STE 201, CORONA, CA 92882-5303
(951) 279-3222
Mailing address
1235 EMERALD ST, HEMET, CA 92543-7812
(562) 416-8285
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
CA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
03/31/2023
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