Individual
MR. DELEON DEVAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
232 E HOUSTON ST, COALINGA, CA 93210-2614
(626) 644-5665
Mailing address
232 E HOUSTON ST, COALINGA, CA 93210-2614
(626) 644-5665
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41083
CA
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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