Individual
CRISTINA SOARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
1241 SHAWN CT, LATHROP, CA 95330-9335
(209) 814-2960
Mailing address
1241 SHAWN CT, LATHROP, CA 95330-9335
(209) 814-2960
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT37715
CA
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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