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Individual

MR. JASON RUSSEL D'AMICO

Active
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Individual

MR. JASON RUSSEL D'AMICO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPT

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
PT27519
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
CA

Other

Enumeration date
09/20/2006
Last updated
02/22/2023
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