Individual
DESTINIE T GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSA
Contact information
Practice address
43520 DIVISION ST, LANCASTER, CA 93535-4089
(661) 266-4783
(661) 266-1210
Mailing address
43520 DIVISION ST, LANCASTER, CA 93535-4089
(661) 266-4783
(661) 266-1210
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
06/06/2011
Last updated
06/06/2011
About Stedi
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