Individual
VANESSA LAVETTE VERJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
850 E FOOTHILL BLVD, RIALTO, CA 92376-5230
(909) 750-1002
(909) 421-9392
Mailing address
850 E FOOTHILL BLVD, RIALTO, CA 92376-5230
(909) 421-9475
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40647
CA
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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