Individual
LESLEY SIHAVONG VANNOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13731 DELLBROOK ST, EASTVALE, CA 92880-5521
(951) 847-5476
Mailing address
7056 ARCHIBALD AVE # 102-322, EASTVALE, CA 92880-8713
(951) 847-5476
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
CA
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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