Individual
DESIRAE MARIE IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
9864 BALDWIN PL, EL MONTE, CA 91731-2202
(626) 433-1311
Mailing address
9864 BALDWIN PL, EL MONTE, CA 91731-2202
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42624
CA
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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