Individual
KIFLE TSEGAW MELISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
1215 1ST ST, GILROY, CA 95020-4733
(408) 852-2481
Mailing address
9700 SEDONA WAY, GILROY, CA 95020-9617
(408) 476-1559
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40207
CA
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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