Individual
SONNIE M DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2343 ARCHWOOD LN, SUITE 141, SIMI VALLEY, CA 93063-6142
(805) 795-3260
Mailing address
2343 ARCHWOOD LN, SUITE 141, SIMI VALLEY, CA 93063-6142
(805) 795-3260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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