Individual
ANGEL TISCARENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 E 15TH ST, MERCED, CA 95341-6217
(209) 386-1092
Mailing address
300 E 15TH ST STE C, MERCED, CA 95341-6217
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/06/2021
Last updated
12/20/2021
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