Individual
JOSE SAUCEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 903-1905
(805) 903-1905
Mailing address
9312 BOCINA LN APT C, ATASCADERO, CA 93422-6856
(805) 369-3287
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40259
CA
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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