Individual
DEWEY HENRY CRUZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4890
Mailing address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4890
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT35234
CA
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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