Individual
HEATHER RENAE ISHIDA GIDCUMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11835 W OLYMPIC BLVD STE 815E, LOS ANGELES, CA 90064-5056
(323) 332-9905
Mailing address
5873 E ALEXANDER AVE, FRESNO, CA 93727-9800
(951) 312-1173
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/06/2019
Last updated
08/08/2024
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