Individual
ERICA Y FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
(626) 962-4471
Mailing address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
(626) 962-4471
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT34421
CA
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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