Individual
DELICIA PROMISE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
629 12TH ST, MODESTO, CA 95354-2424
(209) 558-9675
(209) 558-2154
Mailing address
629 12TH ST, MODESTO, CA 95354-2424
(209) 558-9675
(209) 558-2154
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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