CRISELLE JANE CARILLO SUMAMPONG

STOCKTON, CA
NPI1073121414
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy167G00000X Licensed Psychiatric Technician
(Licence: CA  41696)
Enumeration Date2020-07-22
Last Update Date2020-07-22
Business Address
CRISELLE JANE CARILLO SUMAMPONG
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8686
Mailing Address
CRISELLE JANE CARILLO SUMAMPONG
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8686
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