Individual
MR. GODWIN KEBILA KABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
344 LOS PINOS WAY, SAN JOSE, CA 95123-5117
(408) 759-1924
Mailing address
344 LOS PINOS WAY, SAN JOSE, CA 95123-5117
(408) 759-1924
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT37777
CA
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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