Individual
PHILLIP ALAN MACKECHNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCH TECH
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4711
(805) 781-1272
Mailing address
PO BOX 1255, ATASCADERO, CA 93423-1255
(805) 234-3294
(805) 781-1272
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT30974
CA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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