Individual
GEMA KARINA FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3620 JUSTIN CT, MODESTO, CA 95355-3698
(209) 605-7417
Mailing address
3620 JUSTIN COURT, MODESTO, CA 95355-3698
(209) 605-7417
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
0128782007
CA
Other
Enumeration date
09/13/2017
Last updated
07/21/2022
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