Individual
LISETTE FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22331 MISSION BLVD, HAYWARD, CA 94541-3911
(510) 471-5907
(510) 690-0703
Mailing address
22331 MISSION BLVD, HAYWARD, CA 94541-3911
(510) 471-5907
(510) 690-0703
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95002194
CA
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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