Individual
ESTEFANIA DE JESUS MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
500 W HOSPITAL RD, FRENCH CAMP, CA 95231-9693
(559) 936-8135
Mailing address
3062 ASHTON ST, LODI, CA 95242-8801
(559) 936-8135
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95018233
CA
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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