Individual
CAMILLE ROLDAN MARIATEGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
237 RACE ST, SAN JOSE, CA 95126-4823
(408) 971-9822
(408) 971-9820
Mailing address
237 RACE ST, SAN JOSE, CA 95126-4823
(408) 971-9822
(408) 971-9820
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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