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1699428995
LUKAS WYATT OTTESON
GILROY, CA
NPI
1699428995
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2022-01-27
Last Update Date
2022-01-27
Business Address
LUKAS WYATT OTTESON
9015 MURRAY AVE STE 100
GILROY, CA 95020-3675
Phone number: 408-842-7138
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Mailing Address
LUKAS WYATT OTTESON
7136 EAGLE RIDGE DR
GILROY, CA 95020-3046
Phone number: 760-759-3865
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