Individual
EDI GARCIA TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 300-8898
Mailing address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 300-8898
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42554
CA
372600000X
Adult Companion
42554
CA
Other
Enumeration date
09/07/2023
Last updated
03/21/2026
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