Individual
LISA LATIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 W CLINTON AVE BLDG W, FRESNO, CA 93705-4206
(559) 264-7521
Mailing address
1095 W SAN RAMON AVE, FRESNO, CA 93711-3150
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN95232824
CA
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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