Individual
ANTONELLA DE LA TORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
411 E LAKE AVE, WATSONVILLE, CA 95076-4424
(831) 728-6445
Mailing address
411 E LAKE AVE, WATSONVILLE, CA 95076-4424
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
156396
CA
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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