Individual
MAYRA QUEZADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3569 LEXINGTON AVE, EL MONTE, CA 91731-2607
(626) 453-3399
Mailing address
6771 ORIZABA AVE, LONG BEACH, CA 90805-1934
(310) 714-2683
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT37417
CA
Other
Enumeration date
04/25/2014
Last updated
04/28/2016
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