Individual
JERAMY BERNARD SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
314 12TH ST, VALLEJO, CA 94590-6469
(415) 503-7812
Mailing address
314 12TH ST, VALLEJO, CA 94590-6469
(415) 503-7812
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42359
CA
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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