Individual
ROCIO IVETTE VILLASENOR BALCAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 W G ST, LOS BANOS, CA 93635-3657
(209) 710-6132
Mailing address
40 W G ST, LOS BANOS, CA 93635-3657
(209) 710-6132
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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