Individual
PATRICIA LYNETT COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-6247
Mailing address
251 E HACKETT RD, MODESTO, CA 95358-9800
(209) 604-3728
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/02/2018
Last updated
05/22/2025
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