Individual
LANEE TATIANA MERCEIDES HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 GARY AVE, ANTIOCH, CA 94509-2763
(925) 779-7520
Mailing address
29516 KOHOUTEK WAY, UNION CITY, CA 94587-1221
(510) 362-0827
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
4509
CA
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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