Individual
HUMBERTO ANDRADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8700
Mailing address
1405 STONEWOOD AVE APT 106, MANTECA, CA 95336-3114
(209) 561-8912
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41571
CA
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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