Individual
DESTINY VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4850 PEDLEY RD, JURUPA VALLEY, CA 92509-3966
(951) 416-1572
Mailing address
4850 PEDLEY RD, JURUPA VALLEY, CA 92509-3966
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
11/20/2020
Last updated
07/10/2023
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