Individual
DEBRA K MENDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 SUNNY HEIGHTS DR, FORTUNA, CA 95540-1618
(707) 845-0806
Mailing address
2000 SUNNY HEIGHTS DR, FORTUNA, CA 95540-1618
(707) 845-0806
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
A1234654
CA
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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