Individual
MRS. LAURIE IRENE DAVIS MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
797 W CHILDS AVE, MERCED, CA 95341-6805
(866) 682-4842
(209) 383-1402
Mailing address
737 W CHILDS AVE, MERCED, CA 95341-6805
(866) 682-4842
(209) 383-1402
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
16800
CA
Other
Enumeration date
04/02/2010
Last updated
11/15/2019
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