Individual
BRENDA CARMEN RAZOUKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8717 FLETCHER PKWY APT 351, LA MESA, CA 91942-3243
(619) 565-8363
Mailing address
2639 W CANYON AVE APT 474, SAN DIEGO, CA 92123-4703
(619) 565-8683
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7548540
DRIVER LICENSE
CA
Enumeration date
01/15/2021
Last updated
02/01/2021
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