Individual
CHARITO AGUILAR RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
300 ILENE ST, MARTINEZ, CA 94553-2631
(925) 313-7980
(925) 646-2060
Mailing address
1230 LOCUST DR, VALLEJO, CA 94591-4309
(707) 319-6045
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
33141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9222028
HEALTH INSURANCE
—
Enumeration date
09/18/2020
Last updated
09/18/2020
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