Individual
MS. RAQUEL CASANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICE TECHNICIAN
Contact information
Practice address
1333 E DR MARTIN LUTHER KING JR BLVD, STOCKTON, CA 95205-6913
(209) 290-8793
Mailing address
1333 E DR MARTIN LUTHER KING JR BLVD, STOCKTON, CA 95205-6913
(209) 290-8793
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
2000134184
CA
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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