Individual
BETSY A PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 E 15TH ST STE C, MERCED, CA 95341-6217
(109) 238-6209
Mailing address
300 E 15TH ST STE C, MERCED, CA 95341-6217
(209) 386-1092
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
712112
CA
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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