Individual
MARTHA VALLEJO DIAZ
Active
Individual
MARTHA VALLEJO DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
29462
CA
Other
Enumeration date
06/03/2016
Last updated
02/02/2021
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