Individual
KYLE DOMINIC DE VERA CESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4411 E CESAR CHAVEZ BLVD, FRESNO, CA 93702-3604
(559) 600-7180
Mailing address
4411 E CESAR CHAVEZ BLVD, FRESNO, CA 93702-3604
(559) 600-7180
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95397794
CA
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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