Individual
MRS. LUZ STACY LOERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1000
Mailing address
1096 PENNSYLVANIA AVE, COLTON, CA 92324-2260
(909) 512-2960
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 36880
CA
Other
Enumeration date
07/14/2014
Last updated
05/01/2015
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