Humberto Andrade
Licensed Psychiatric Technician in Stockton, CA. Individual provider (NPI-1).
NPI number1205460482
StatusActive
Last updated in NPPESFeb 27, 2020
Details
- NPI
- 1205460482
- Entity type
- Individual (NPI-1)
- Name
- Humberto Andrade
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 27, 2020
- Certification date
- Feb 27, 2020
- Last updated
- Feb 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 167G00000X | Licensed Psychiatric Technician | 41571 | CA | Yes |
Practice location
1212 N California StStockton, CA 95202-1552
Phone 209-468-8700
Mailing address
1405 Stonewood Ave Apt 106Manteca, CA 95336-3114
Phone 209-561-8912
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