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1326639964
ANDRA AMORY WASKET
FONTANA, CA
NPI
1326639964
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA 41806)
Enumeration Date
2021-01-27
Last Update Date
2021-01-27
Business Address
ANDRA AMORY WASKET
14677 MERRILL AVE
FONTANA, CA 92335-4219
Phone number: 951-643-2340
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Mailing Address
ANDRA AMORY WASKET
277 BLOOMINGTON AVE UNIT 235
RIALTO, CA 92376-6495
Phone number: 909-222-5967
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