Individual
MIRANDA CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 SW BRUMBACK ST UNIT 2753, MCMINNVILLE, OR 97128-6899
(805) 754-6423
Mailing address
PO BOX 8143, OXNARD, CA 93031-8143
(805) 754-6423
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/09/2018
Last updated
07/08/2019
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