Individual
DEANDRA LEERINE BUCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 TULLY RD, MODESTO, CA 95350-0811
(209) 576-2283
(209) 576-2838
Mailing address
3200 TULLY RD, MODESTO, CA 95350-0811
(209) 576-2283
(209) 576-2838
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171400000X
Health & Wellness Coach
Primary
—
CA
Other
Enumeration date
11/13/2024
Last updated
04/21/2026
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