Individual
MARY A ELESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7636 MONTEREY AVE, CERES, CA 95307-9542
(209) 622-6751
Mailing address
7636 MONTEREY AVE, CERES, CA 95307-9542
(209) 622-6751
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
08/29/2022
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