Organization
DMH
Active
Organization
DMH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA MINNETTE CLARKSON (PSYCHIATRIC TECHNICIAN)
(626) 643-1305
Entity
Organization
Contact information
Practice address
16213 FELLOWSHIP ST, LA PUENTE, CA 91744-1327
(626) 643-1305
Mailing address
16213 FELLOWSHIP, LA PUENTE, CA 91744
(626) 643-1305
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
PT35293
CA
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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