MARIA THERESA LICERALDE WYSON

ELK GROVE, CA
NPI1861769648
Former NameMARIA THERESA SIDECO LICERALDE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: CA  21360)
Enumeration Date2011-11-22
Last Update Date2023-03-07
Business Address
MARIA THERESA LICERALDE WYSON MSN, FNP-C
7811 LAGUNA BLVD STE 161
ELK GROVE, CA 95758-7949
Phone number: 916-877-7778
Mailing Address
MARIA THERESA LICERALDE WYSON MSN, FNP-C
11592 LINDAY WAY
GOLD RIVER, CA 95670-6233
Phone number: 916-213-2570