Individual
STEVEN GASTELUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4712
(805) 781-4145
Mailing address
8595 SAN ANDRES AVE., ATASCADERO, CA 93422
(805) 462-2809
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 30628
CA
Other
Enumeration date
06/14/2016
Last updated
06/15/2016
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