Individual
DAISY DORALI CORPUS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4441 E CESAR CHAVEZ BLVD, FRESNO, CA 93702-3604
(559) 600-9171
Mailing address
12466 AVENUE 415, OROSI, CA 93647-2116
(559) 419-3612
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
733649
CA
164X00000X
Licensed Vocational Nurse
Primary
733649
CA
Other
Enumeration date
11/16/2023
Last updated
03/28/2025
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