Individual
KENNETH JOHN PERALTA SANGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14659 OLIVE VIEW DR, SYLMAR, CA 91342-1652
(818) 485-0888
(818) 833-5690
Mailing address
14659 OLIVE VIEW DR, SYLMAR, CA 91342-1652
(818) 485-0888
(818) 833-5690
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT36258
CA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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