Individual
ALYSA MAREN SPARKMAN-MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 300-8800
Mailing address
2283 WHISPER WAY, ATWATER, CA 95301-2563
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
820878
CA
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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