Individual
JACOB ALEXANDER DAHNEKE I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11401 BLOOMFIELD AVE, NORWALK, CA 90650-2015
(530) 559-3820
Mailing address
PO BOX 695, SUMMERLAND, CA 93067-0695
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
28078
CA
Other
Enumeration date
03/28/2012
Last updated
03/29/2012
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