Individual
CELESTE ROSE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 W TOKAY ST, LODI, CA 95240-3845
(209) 331-2070
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT40655
CA
Other
Enumeration date
02/06/2018
Last updated
03/17/2018
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