Individual
MISS DEMESTRICE SHERISE MATHIS V
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
32845 SANTA CRUZ, 3822NEWARK CT, LAKE ELSINORE, CA 92530-0468
(951) 588-7713
Mailing address
32845 SANTA CRUZ, LAKE ELSINORE, CA 92530-0468
(951) 588-7713
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN192486
CA
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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