Individual
DIANNE BARTOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 S TUSTIN ST BLDG D, ORANGE, CA 92866-2550
(714) 289-3936
Mailing address
401 S TUSTIN ST BLDG D, ORANGE, CA 92866-2550
(714) 289-3936
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41775
CA
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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