Individual
MS. JUDEE H CARRICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2032 THOMPSON CT STE 12, MONTROSE, CA 91020-1652
(818) 249-5489
Mailing address
2746 EL CAMINITO, LA CRESCENTA, CA 91214-2932
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6253
ELECTROLOGIST LICENSE
CA
Enumeration date
09/25/2017
Last updated
09/25/2017
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