Individual
DESIREE MARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11541 ROSECRANS AVE, NORWALK, CA 90650-3898
(625) 923-9414
Mailing address
11541 ROSECRANS AVE, NORWALK, CA 90650-3898
(562) 923-9414
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
07/25/2016
Last updated
05/16/2024
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