Individual
ANTONIA VASQUEZ MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N PALM CANYON DR, A4, PALM SPRINGS, CA 92262-1868
(442) 268-7000
Mailing address
1775 E. PALM CANYON DRIVE, SUITE 110, #373, PALM SPRINGS, CA 92262
(442) 268-7000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/25/2014
Last updated
11/30/2016
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