Individual
MATTHEW ROBIN DEVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCH TECH
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 834-7004
Mailing address
9283 LITTLE CREEK CIR, STOCKTON, CA 95210-4489
(209) 834-7004
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36601
CA
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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