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1114481744
ERICK MATIENZO
STOCKTON, CA
NPI
1114481744
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-01-28
Last Update Date
2019-01-28
Business Address
Mr. ERICK MATIENZO
2495 W MARCH LN STE 125
STOCKTON, CA 95207-8224
Phone number: 209-320-7633
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Mailing Address
Mr. ERICK MATIENZO
2495 W MARCH LN STE 125
STOCKTON, CA 95207-8224
Phone number: 209-320-7633
Copy
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