Individual
AGATHA N IHENACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
455 SILICON VALLEY BLVD, SAN JOSE, CA 95138
(408) 284-9000
Mailing address
6381 BLACKBERRY CT, GILROY, CA 95020-3424
(408) 848-9802
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT31594
CA
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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