Individual
ANA BUSTAMANTE LAUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-3200
Mailing address
945 CENTRE COURT DR, TRACY, CA 95376-4910
(650) 544-7545
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
124992
CA
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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