Individual
MARY ISABEL HURTADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
160 E HOLT AVE STE B, POMONA, CA 91767-5407
(909) 620-2521
Mailing address
952 W 4TH ST, POMONA, CA 91766-1425
(909) 997-8384
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
—
—
Other
Enumeration date
02/14/2012
Last updated
12/12/2013
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