Individual
MISS ALICIA RAE TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3815 MARCONI AVE, SACRAMENTO, CA 95821-3867
(916) 890-3000
Mailing address
3815 MARCONI AVE, SACRAMENTO, CA 95821-3867
(916) 890-3000
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
700788
CA
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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