Individual
KEVIN NITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
—
CA
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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