THARITH VONG

STOCKTON, CA
NPI1134624802
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy167G00000X Licensed Psychiatric Technician
(Licence: CA  40678)
Enumeration Date2018-03-26
Last Update Date2018-03-26
Business Address
THARITH VONG
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-0102
Mailing Address
THARITH VONG
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-0102