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General NPI Number Information
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NPI Number | 1265606909
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Entity Type | Individual
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Provider Name | MARY DELISLE
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Gender | Female
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 684 HARRISON RD
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City | SALINAS
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State | CA
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Zip | 93907-1660
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Country | US
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Telephone | 831-443-5225
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 730276
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City | SAN JOSE
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State | CA
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Zip | 95173-0276
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Country | US
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Telephone | 408-971-9822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW16880
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License Number State | CA
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