Individual
GENESIS FLORES I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
265 S ANITA DR, ORANGE, CA 92868-3355
(949) 749-2500
Mailing address
2120 S LEWIS ST APT 203, ANAHEIM, CA 92802-5035
(562) 219-6167
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT38291
CA
Other
Enumeration date
11/14/2018
Last updated
08/26/2024
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