Individual
BETSY PEREIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 E VINE ST, LODI, CA 95240-3148
(209) 904-0035
Mailing address
1305 E VINE ST, LODI, CA 95240-3148
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
111093
CA
Other
Enumeration date
05/03/2021
Last updated
04/10/2024
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