Individual
AMANDA DEMATTEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 E 13TH ST STE D, MERCED, CA 95341-6211
(298) 386-1096
Mailing address
2250 DRAKE AVE, MERCED, CA 95348-4034
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN695590
CA
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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