Individual
DAWN STOCKHAUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58945 BUSINESS CENTER DR, YUCCA VALLEY, CA 92284-7307
(760) 369-4015
Mailing address
1316 S MEADOW LN APT 265, COLTON, CA 92324-6427
(909) 532-4198
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT37826
CA
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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