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Individual

CORINA ROCHELLE BURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3706 CALAVO DR, SPRING VALLEY, CA 91977-1903
(619) 779-9058
Mailing address
8750 MELLMANOR DR APT 30, LA MESA, CA 91942-3162
(619) 493-6334

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Y9223414
DRIVER LICENSE
CA
Enumeration date
09/17/2020
Last updated
09/17/2020
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