| Street | 210 W 15th St | ||
| City/Town | Merced | ||
| State/Province/Region | California | ||
| Zip/Postal Code | 95340 | ||
| Phone Number | (209) 384-2190 | ||
| Country | United States |
| Full Name | Dominique Wiza | ||
| Gender | female | ||
| Birthday | 1980-10-10 | ||
| Social Security Number | 419-67-3587 |
| Credit card brand | EnRoute | ||
| Credit card number | 2014901686015313 | ||
| Expire | 2029/3 | ||
| CVV | 748 |