Individual
BETHANY SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
968 CORTE MARIA AVE, CHULA VISTA, CA 91911-2219
(619) 754-9551
Mailing address
968 CORTE MARIA AVE, CHULA VISTA, CA 91911-2219
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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