Individual
JUSTIN MANUEL AMARAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4501 TAFT AVE, RICHMOND, CA 94804-3449
(510) 235-3172
Mailing address
180 RIVERVIEW DR, PITTSBURG, CA 94565-5732
(925) 519-1371
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
075600636
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101Y00000X
MEDICAL
CA
Enumeration date
06/15/2011
Last updated
06/15/2011
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