Individual
MARIO A VENTURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 S 2ND AVE, COVINA, CA 91723-3012
(626) 974-8123
(626) 974-8198
Mailing address
508 S 2ND AVE, COVINA, CA 91723-3012
(626) 974-8123
(626) 974-8198
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT33938
CA
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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