Individual
DOMEVLO UMOJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
2550 W CLINTON AVE BLDG W, FRESNO, CA 93705-4206
(559) 264-7521
(559) 860-0168
Mailing address
2550 W CLINTON AVE UNIT 397, FRESNO, CA 93705-4223
(559) 264-7521
(559) 860-0168
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 276219
CA
164X00000X
Licensed Vocational Nurse
VN276219
CA
Other
Enumeration date
05/28/2014
Last updated
09/17/2020
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