Individual
JOHN DREW HENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
212 CARMEN LN, SANTA MARIA, CA 93458-7769
(805) 212-7680
Mailing address
212 CARMEN LN, SANTA MARIA, CA 93458-7769
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41980
CA
Other
Enumeration date
11/19/2024
Last updated
11/30/2024
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