Individual
PERLA REVELES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2316 AVILES, MERCED, CA 95340-5567
(559) 829-7811
Mailing address
2316 AVILES, MERCED, CA 95340-5567
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40931
CA
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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