Individual
LACY DANIELLE COUCHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1 MEDICAL PLAZA DR, ROSEVILLE, CA 95661-3037
(916) 781-1750
Mailing address
2207 SANDCASTLE WAY, SACRAMENTO, CA 95833-2399
(916) 248-0039
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00937122
CA
Other
Enumeration date
04/02/2020
Last updated
04/02/2020
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