ECSTACY PERALTA

DINUBA, CA
NPI1659774602
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  51945)
Enumeration Date2014-10-06
Last Update Date2021-04-19
Business Address
ECSTACY PERALTA
468 N VERMONT AVE
DINUBA, CA 93618-1631
Phone number: 559-591-6200
Mailing Address
ECSTACY PERALTA
321 W CHENNAULT AVE APT 225
CLOVIS, CA 93611-0217
Phone number: 408-420-4628
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