Individual
LACEY NICOLE RECINOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 E 15TH ST, MERCED, CA 95341-6217
(209) 381-6879
Mailing address
1435 SAN FRANCISCO ST, LOS BANOS, CA 93635-8293
(408) 603-1460
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
CA
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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