Individual
WONANI MHANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
Mailing address
9310 MADURO LN, APT. G, ATASCADERO, CA 93422-5898
(951) 522-9399
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 36346
CA
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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