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1114399581
KENNETH JOHN PERALTA SANGA
SYLMAR, CA
NPI
1114399581
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA PT36258)
Enumeration Date
2015-10-26
Last Update Date
2015-10-26
Business Address
-- KENNETH JOHN PERALTA SANGA
14659 OLIVE VIEW DR
SYLMAR, CA 91342-1652
Phone number: 818-485-0888
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Mailing Address
-- KENNETH JOHN PERALTA SANGA
14659 OLIVE VIEW DR
SYLMAR, CA 91342-1652
Phone number: 818-485-0888
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