Individual
KARINA VIZCARRA
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
Mailing address
13247 FOOTHILL BLVD, 12202, RANCHO CUCAMONGA, CA 91739-9677
(909) 559-1658
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37744
CA
167G00000X
Licensed Psychiatric Technician
—
CA
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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