Individual
KATHRYN VIRGINIA MANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5887 BROCKTON AVE, RIVERSIDE PSYCHIATRIC MEDICAL GROUP STE A, RIVERSIDE, CA 92506
(951) 275-8500
(951) 275-8560
Mailing address
5887 BROCKTON AVE, RIVERSIDE PSYCHIATRIC MEDICAL GROUP STE A, RIVERSIDE, CA 92506
(951) 275-8500
(951) 275-8560
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY8997
CA
Other
Enumeration date
09/11/2006
Last updated
07/08/2007
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