Individual
MICHELLE PONGOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PATTERSON BLVD, PLEASANT HILL, CA 94523-4155
(925) 938-8050
Mailing address
550 PATTERSON BLVD, PLEASANT HILL, CA 94523-4155
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
38163
CA
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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