Individual
ELOISE TINA JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 W TEMPLE ST, LOS ANGELES, CA 90012-3208
(213) 971-0515
Mailing address
1738 HOLLY DR, GLENDALE, CA 91206-4115
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
23560
CA
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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