Individual
GERHARD SITUMORANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7959 ORANGE AVE, FAIR OAKS, CA 95628-5916
(916) 307-0478
Mailing address
4822 TOMMAR DR, FAIR OAKS, CA 95628-5128
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
32748
CA
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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