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Individual

PORSCHE LOZADA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
(909) 865-9281
Mailing address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
(909) 865-9281

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT37829
CA

Other

Enumeration date
09/22/2015
Last updated
09/22/2015
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