Individual
MISS BRENDA MARIE STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
941 HAYCASTLE CT, NEWMAN, CA 95360-9541
(209) 695-8421
Mailing address
941 HAYCASTLE CT, NEWMAN, CA 95360-9541
(209) 695-8421
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
PT32772
CA
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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