Individual
MRS. YESENIA DICOCHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
424 E PRESIDENT, TUCSON, AZ 85714
(520) 806-8025
(520) 806-8035
Mailing address
424 E PRESIDENT, TUCSON, AZ 85714
(520) 806-8025
(520) 806-8035
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALH-6231
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117961
AHCCCS PROVIDER NUMBER
AZ
Enumeration date
07/16/2008
Last updated
07/16/2008
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