Lisa Phetchamphone
NPI #1164167136 in Ceres, California
Provider Information
- NPI Number
- 1164167136
- Entity Type
- Individual
- Name
- Lisa Phetchamphone
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Licensed Vocational Nurse
- Enumeration Date
- May 3, 2022
- Last Updated
- May 3, 2022
Practice Location
- Address
- 1768 MITCHELL RD
- City
- Ceres
- State
- California
- ZIP Code
- 95307-2156
- Phone
- (209) 353-4838
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Vocational Nurse |
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