Individual
MEGAN COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
303 S C ST, LOMPOC, CA 93436-7305
(805) 305-8885
Mailing address
303 S C ST, LOMPOC, CA 93436-7305
(805) 308-8720
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37159
CA
Other
Enumeration date
04/17/2015
Last updated
10/29/2024
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