Individual
GERALD DIAZ SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1630 E SHAW AVE STE 150, FRESNO, CA 93710-8109
(559) 909-4355
Mailing address
1630 E SHAW AVE, #150, FRESNO, CA 93710-8105
(559) 909-4355
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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