Individual
CARLOS JACOBO ADAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17270 ROOSEVELT ST, RIVERSIDE, CA 92508-9523
(951) 683-6596
Mailing address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
(951) 683-6596
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40748
CA
Other
Enumeration date
03/27/2019
Last updated
12/06/2023
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