Individual
DR. AIESKA DE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MSC
Contact information
Practice address
8220 WYMARK DR, ELK GROVE, CA 95757-6297
(916) 667-0600
(916) 683-0232
Mailing address
3400 DATA DR, CREDENTIALING, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
250593
MA
207N00000X
Dermatology Physician
Primary
A137775
CA
Other
Enumeration date
09/30/2008
Last updated
09/18/2015
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