Individual
DAN LEROY FAUCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1501 CLAUS RD, MODESTO, CA 95355-9711
(209) 558-4700
Mailing address
2621 MAJESTIC OAK DR, MODESTO, CA 95355-9402
(209) 551-5733
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
337314
CA
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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