Individual
LEIA IRIS NEVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3161 DWIGHT RD, ELK GROVE, CA 95758-6456
(916) 364-8395
Mailing address
3161 DWIGHT RD, ELK GROVE, CA 95758-6456
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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