Individual
PATRICK KYLE CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCH TECH
Contact information
Practice address
640 EMAN CT, ARROYO GRANDE, CA 93420-3222
(928) 542-9079
Mailing address
640 EMAN CT, ARROYO GRANDE, CA 93420-3222
(928) 542-9079
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT36895
CA
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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