Individual
KELLIE DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COA
Contact information
Practice address
7777 E FREEDOM RD, FRENCH CAMP, CA 95231-9694
(209) 946-3400
Mailing address
6443 OAKRIDGE WAY, SACRAMENTO, CA 95831-2233
(916) 204-5672
Taxonomy
Speciality
Code
Description
License number
State
156FX1101X
Ophthalmic Assistant
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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