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1962702266
JONATHAN BAUTISTA
OAKLAND, CA
NPI
1962702266
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA LMFT#95892)
Enumeration Date
2010-11-02
Last Update Date
2016-10-21
Business Address
-- JONATHAN BAUTISTA
629 OAKLAND AVE
OAKLAND, CA 94611-4567
Phone number: 510-984-8722
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Mailing Address
-- JONATHAN BAUTISTA
629 OAKLAND AVE
OAKLAND, CA 94611-4567
Phone number: 510-984-8722
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