Individual
THERESA PATRICE LOPEZ RAVAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2923 WEBSTER ST STE 201, OAKLAND, CA 94609-3418
(510) 752-8330
Mailing address
2505 HAZELWOOD AVE, STOCKTON, CA 95207-1309
(209) 337-8227
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Enumeration date
07/08/2021
Last updated
01/11/2022
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