Individual
RASCEL DATUIN-INTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1756 S LEWIS RD, CAMARILLO, CA 93012-8520
(805) 383-3669
(805) 987-5422
Mailing address
632 KIRK AVE, VENTURA, CA 93003-5064
(805) 383-3669
(805) 987-5422
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
33937
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326124579
ARF
—
Enumeration date
05/01/2008
Last updated
05/01/2008
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