Individual
SANDY PANKRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4711
Mailing address
129 W JONES ST APT C, SANTA MARIA, CA 93458-5675
(805) 352-9294
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT27406
CA
Other
Enumeration date
01/26/2007
Last updated
11/17/2008
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