Individual
HALEY LISSETHE MONTIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 S AIRPORT WAY, MANTECA, CA 95337-8426
(209) 825-1350
Mailing address
401 S AIRPORT WAY, MANTECA, CA 95337-8426
(209) 825-1350
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
751851
CA
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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