Individual
SUSANA OLIVA MENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
5200 SAN GABRIEL PL STE C, PICO RIVERA, CA 90660-2498
(562) 222-1331
(562) 222-1322
Mailing address
5200 SAN GABRIEL PL STE C, PICO RIVERA, CA 90660-2498
(562) 222-1331
(562) 222-1322
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40387
CA
Other
Enumeration date
07/14/2017
Last updated
07/21/2022
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