Individual
LINDA AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 923-0915
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37757
CA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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