Individual
PATRICIA GUEVARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335-4219
(951) 643-2340
Mailing address
5056 WASHINGTON AVE, CHINO, CA 91710-3436
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41270
CA
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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