Individual
LESLEY GONZALEZ HURTADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 MCHENRY AVE STE A&B, MODESTO, CA 95350-5370
(209) 527-4597
Mailing address
1235 MCHENRY AVE STE A&B, MODESTO, CA 95350-5370
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42134
CA
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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